尼日利亚拉各斯职业男性长途卡车司机心血管疾病风险人群中慢性肾脏病阳性筛查的流行率：一项横断面研究。
Prevalence of positive chronic kidney Disease screening in professional male long haul drivers at risk of cardiovascular Disease in Lagos, Nigeria: a cross-section study.
机构信息
Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria.
出版信息
BMC Public Health. 2019 Aug 1;19(1):1032. doi: 10.1186/s12889-019-7328-6.
BACKGROUND
Professional drivers are known to be at high risk for cardiovascular disease (CVD) on account of the higher prevalence co-occurring risk factors they harbour. Chronic kidney disease (CKD) and CVD share similar risk factors. Both impact each other adversely. The renal profile of professional drivers in Nigeria is not well characterised. We decided to study the prevalence of positive CKD screening amongst professional male long distance drivers in Lagos, Southwest Nigeria so as to quantify the burden and its predictors.
METHODS
Two hundred and ninety-three drivers were recruited. Details of their socio-demographic characteristics were obtained. Their anthropometric indices, blood pressure, fasting plasma blood glucose and lipid profile were measured. Serum creatinine was measured and estimated glomerular filtration rate, eGFR, was calculated with Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Urinary Albumin Creatinine Ratio (UACR) was determined. A 10 year CVD risk of the subjects was calculated with the Framingham Risk Score (FRS).
RESULTS
Mean age of the study population was 44.8 + 9.7 years. The prevalence of alcohol use and smoking were 71.0 and 19.5% respectively. One hundred and twenty-one (62.8%) of the subjects were either overweight or obese while 70(24.1%) had abdominal obesity. The prevalence of hypertension and diabetes were 39.7 and 13.9% respectively. Prevalence of CKD by eGFR< 60 ml/min/1.73m or UACR > 30 mg/g was 51.7% (95% CI; 46.0-57.5). The odds for CKD increased with lower HDL-c levels; OR 3.5 (95% CI, 1.1-11.2; p = 0.03) and longer duration of professional driving > 20 years; OR 2.4(95% CI, 1.5-4.0).
CONCLUSION
Professional male long distance drivers in addition to having very high prevalence of clustering of both CVD and CKD risk factors have a significant burden of asymptomatic CKD. UACR appears to be an earlier marker of CKD in this population. Health awareness promotion and aggressive risk factor reduction are advocated as ways to reduce this burden.
背景
由于职业司机普遍存在多种共同的心血管疾病（CVD）风险因素，因此他们患 CVD 的风险较高。慢性肾脏病（CKD）和 CVD 具有相似的风险因素，两者相互不利地影响。尼日利亚职业男性长途司机的肾脏状况尚未得到充分描述。我们决定研究拉各斯（尼日利亚西南部城市）职业男性长途司机中 CKD 筛查阳性的患病率，以量化其负担及其预测因素。
方法
招募了 293 名司机。获取了他们的社会人口统计学特征的详细信息。测量了他们的人体测量指数、血压、空腹血糖和血脂谱。测量了血清肌酐，并使用慢性肾脏病流行病学合作（CKD-EPI）方程计算了估算肾小球滤过率（eGFR）。测定了尿白蛋白肌酐比（UACR）。使用 Framingham 风险评分（FRS）计算了受试者的 10 年 CVD 风险。
结果
研究人群的平均年龄为 44.8 ± 9.7 岁。饮酒和吸烟的患病率分别为 71.0%和 19.5%。121 名（62.8%）受试者超重或肥胖，70 名（24.1%）受试者腹部肥胖。高血压和糖尿病的患病率分别为 39.7%和 13.9%。根据 eGFR<60 ml/min/1.73m 或 UACR >30 mg/g，CKD 的患病率为 51.7%（95%CI：46.0-57.5）。随着高密度脂蛋白胆固醇（HDL-c）水平的降低，CKD 的可能性增加；OR 3.5（95%CI，1.1-11.2；p=0.03），职业驾驶时间超过 20 年；OR 2.4（95%CI，1.5-4.0）。
结论
除了 CVD 和 CKD 风险因素高度聚集外，职业男性长途司机还患有大量无症状 CKD。在该人群中，UACR 似乎是 CKD 的早期标志物。倡导提高健康意识和积极降低风险因素，以减轻这种负担。
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