Xu Weicheng, Li Chijian, Qian Ge, Huang Yuxiang, Zhao Liqin
Department of Nephrology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
Health Management Center, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2019 Jul 30;39(7):861-866. doi: 10.12122/j.issn.1673-4254.2019.07.18.
To explore the relationship between metabolic syndrome (MS) and the risk for chronic kidney disease (CKD) in premenopausal and postmenopausal women.
We conducted a cross-sectional study among 1346 community-based women from June to October 2012 and collected the data of personal history, lifestyle, physical measures and laboratory indicators. The diagnosis of CKD was established for an eGFR of less than 60 mL/min per 1.73 m or albuminuria. The diagnosis of metabolic syndrome was based on the International Diabetes Federation Guide. According to an epidemiological survey in Guangdong province, women older than 48.9 years were classified as having a postmenopausal status. The prevalence of MS and CKD was determined in both the premenopausal and postmenopausal women, and the association between MS and CKD was analyzed using logistic regression models.
MS was significantly correlated with CKD in premenopausal women in both unadjusted analyses (OR=3.10, 95% : 1.32-7.28, =0.009) and in analysis after adjustment for potential confounders (OR=4.09, 95% : 1.63- 10.32, =0.003). When adjusted for diabetes, hypertension, and hyperuricemia, no correlation was found between MS and CKD in premenopausal women (OR=1.56, 95% : 0.31-7.63, = 0.592); in the unadjusted analyses, MS was significantly correlated with CKD in postmenopausal women ( < 0.001). After further adjustment for age, education status, current smoking, physical inactivity, and current drinking, MS was still significantly correlated with CKD (OR=2.60, 95% : 1.69-3.99, < 0.001). When adjusted for diabetes, hypertension, and hyperuricemia, the correlation between MS and CKD was still significant (OR=1.61, 95% : 1.09-2.37, =0.018). In the unadjusted model, a high blood pressure (OR=2.77, 95%CI: 1.57-4.89, < 0.001), an elevated serum triglyceride level (OR=1.84, 95%: 1.16-2.90, =0.009) and a high fast glucose level (OR=2.07, 95%: 1.30-3.28, =0.002) were all significantly correlated with CKD in postmenopausal women. After adjusting for age, current smoking, current alcohol use, education status and physical inactivity, a high blood pressure (OR=2.28, 95%: 1.22-4.26, =0.01), a high serum triglyceride level (OR=1.71, 95%: 1.03-2.86, =0.039) and a high fast glucose (OR=2.25, 95%: 1.36-3.73, =0.002) were still significantly correlated with CKD in postmenopausal women. Blood pressure, serum triglyceride level, fast glucose, serum HDL cholesterol level and central obesity were not correlated with CKD in either the unadjusted model or adjusted model in premenopausal women ( > 0.05).
MS is correlated with CKD in both premenopausal and postmenopausal women, and the association is dependent on diabetes, hypertension, and hyperuricemia in premenopausal women but not in postmenopausal women.
探讨绝经前和绝经后女性代谢综合征(MS)与慢性肾脏病(CKD)风险之间的关系。
2012年6月至10月,我们对1346名社区女性进行了一项横断面研究,收集了个人病史、生活方式、体格检查和实验室指标等数据。CKD的诊断标准为估算肾小球滤过率(eGFR)低于60 mL/(min·1.73 m²)或存在蛋白尿。代谢综合征的诊断依据国际糖尿病联盟指南。根据广东省的一项流行病学调查,将年龄大于48.9岁的女性归类为绝经后状态。分别确定绝经前和绝经后女性中MS和CKD的患病率,并使用逻辑回归模型分析MS与CKD之间的关联。
在未调整分析中,绝经前女性的MS与CKD显著相关(OR = 3.10,95%CI:1.32 - 7.28,P = 0.009);在调整潜在混杂因素后的分析中也显著相关(OR = 4.09,95%CI:1.63 - 10.32,P = 0.003)。在调整糖尿病、高血压和高尿酸血症后,绝经前女性的MS与CKD之间未发现相关性(OR = 1.56,95%CI:0.31 - 7.63,P = 0.592);在未调整分析中,绝经后女性的MS与CKD显著相关(P < 0.001)。在进一步调整年龄、教育程度、当前吸烟状况、缺乏身体活动和当前饮酒情况后,MS与CKD仍显著相关(OR = 2.60,95%CI:1.69 - 3.99,P < 0.001)。在调整糖尿病、高血压和高尿酸血症后,MS与CKD之间仍存在显著相关性(OR = 1.61,95%CI:1.09 - 2.37,P = 0.018)。在未调整模型中,高血压(OR =
2.77,95%CI:1.57 - 4.89,P < 0.001)、血清甘油三酯水平升高(OR = 1.84,95%CI:1.16 - 2.90,P = 0.009)和空腹血糖水平升高(OR = 2.07,95%CI:1.30 - 3.28,P = 0.002)在绝经后女性中均与CKD显著相关。在调整年龄、当前吸烟状况、当前饮酒情况、教育程度和缺乏身体活动后,高血压(OR = 2.28,95%CI:1.22 - 4.26,P = 0.01)、血清甘油三酯水平升高(OR = 1.71,95%CI:1.03 - 2.86,P = 0.039)和空腹血糖升高(OR = 2.25,95%CI:1.36 - 3.73,P = 0.002)在绝经后女性中仍与CKD显著相关。在未调整模型或调整模型中,绝经前女性的血压、血清甘油三酯水平、空腹血糖、血清高密度脂蛋白胆固醇水平和中心性肥胖与CKD均无相关性(P > 0.05)。
绝经前和绝经后女性的MS均与CKD相关,且这种关联在绝经前女性中依赖于糖尿病、高血压和高尿酸血症,而在绝经后女性中并非如此。