基于横断面研究的日本人群估算肾小球滤过率与动脉僵硬度的二次分析。
Estimated glomerular filtration rate and arterial stiffness in Japanese population: a secondary analysis based on a cross-sectional study.
机构信息
Department of rheumatism for nephropathy, Guizhou Provincial People's Hospital, 83# Zhongshaneast Road, Guiyang, 550001, Guizhou, China.
Department of Immunology and Microbiology, Guiyang College of Traditional Chinese Medicine, 84# ShiDong Road, Guiyang, 550001, Guizhou, China.
出版信息
Lipids Health Dis. 2019 Mar 4;18(1):57. doi: 10.1186/s12944-019-0997-4.
BACKGROUND
Evidence regarding the relationship between estimated glomerular filtration rate (eGFR) and arterial stiffness is limited, and the data analysis is not sufficient to clarify the true relationship between the two. We aimed to investigate the relationship between eGFR and brachial-ankle pulse wave velocity (baPWV) in Japanese.
METHODS
The present study was a cross-sectional study. Nine hundred twelve Japanese men and women, aging 24-84 years old, received a health medical check-up program including the results from baPWV inspection and various standardized questionnaires in a health examination center in Japan. The main outcome measures included eGFR, baPWV, fatty liver and postmenopausal status. Abdominal ultrasonography was used to diagnose fatty liver. Postmenopausal state was defined as beginning 1 year after the cessation of menses.
RESULTS
The average age of the 912 selected participants was 51.5 ± 9.6 years old, and about 57.6% of them were male. The participants' eGFR distribution was median 69.29 (min 39, max 122.28). The results of multivariate linear regression showed eGFR was not independently associated with baPWV after adjusting potential confounders (β = - 1.11, 95%CI -2.25 to 0.03), this is inconsistent with the result of eGFR (quartile) as a categorical variable (p for trend was 0.038). A non-linear relationship was detected between eGFR and baPWV, whose point was 77.05. The effect sizes and the confidence intervals of the left and right sides of inflection point were - 2.80 (- 4.41 to - 1.19) and 1.84 (- 0.50, 4.17), respectively. Subgroup analysis showed, the change in the elderly population is more pronounced (P for interaction = 0.018; - 2.83 with ≤60 year vs - 6.12 with > 60 year). The same trend was also seen in hypertensive people (P for interaction = 0.018; - 4.55 with hypertension vs - 0.82 with non-hypertension).
CONCLUSION
The relationship between eGFR and baPWV is non-linear. eGFR was negatively related to baPWV when eGFR is less than 77.05.
背景
关于估算肾小球滤过率（eGFR）与动脉僵硬度之间关系的证据有限，且数据分析不足以阐明两者之间的真实关系。本研究旨在探讨日本人群中 eGFR 与臂踝脉搏波速度（baPWV）之间的关系。
方法
本研究为横断面研究。912 名年龄在 24-84 岁的日本男女在日本的健康体检中心接受了健康医学检查，包括 baPWV 检查结果和各种标准化问卷。主要观察指标包括 eGFR、baPWV、脂肪肝和绝经后状态。腹部超声用于诊断脂肪肝。绝经后状态定义为绝经后 1 年开始。
结果
912 名入选者的平均年龄为 51.5±9.6 岁，其中约 57.6%为男性。参与者的 eGFR 分布中位数为 69.29（最小 39，最大 122.28）。多变量线性回归结果显示，在调整潜在混杂因素后，eGFR 与 baPWV 无独立相关性（β=-1.11，95%CI-2.25 至 0.03），这与 eGFR（四分位数）作为分类变量的结果不一致（趋势检验 p=0.038）。eGFR 与 baPWV 之间存在非线性关系，拐点为 77.05。拐点左右两侧的效应大小和置信区间分别为-2.80（-4.41 至-1.19）和 1.84（-0.50，4.17）。亚组分析显示，在老年人中变化更为明显（交互作用检验 p=0.018；≤60 岁时为-2.83，>60 岁时为-6.12）。在高血压人群中也存在同样的趋势（交互作用检验 p=0.018；高血压时为-4.55，非高血压时为-0.82）。
结论
eGFR 与 baPWV 之间的关系是非线性的。当 eGFR 小于 77.05 时，eGFR 与 baPWV 呈负相关。
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