饮酒与新发慢性肾脏病指标的相关性:基于全国健康筛查数据的分析。
Association between alcohol intake and measures of incident CKD: An analysis of nationwide health screening data.
机构信息
Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
PLoS One. 2019 Sep 20;14(9):e0222123. doi: 10.1371/journal.pone.0222123. eCollection 2019.
To evaluate the association between alcohol intake and incident chronic kidney disease measures as well as the sex differences in this association, we analyzed health screening data of 14,190,878 adults who underwent health screening ≥3 times and had glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and normal proteinuria at baseline. eGFR was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation. Proteinuria was defined as ≥1+ dipstick proteinuria and low eGFR as <60 mL/min/1.73 m2. The risk of incident proteinuria and low eGFR was analyzed with an extended Cox model with alcohol intake level as a time-varying determinant and the annual change of eGFR with generalized linear model. A J-shape association of alcohol intake with the incident proteinuria was observed in men (adjusted hazard ratio [aHR], 0.961, 95% confidence interval [CI], 0.953-0.970 in men drinking alcohol <10 g/day; aHR 1.139, 95% CI, 1.123-1.154 in men drinking alcohol ≥40 g/day, compared with non-drinking men), and a positive association was seen in women (aHR, 1.034, 95% CI, 1.023-1.044 in women drinking alcohol <10 g/day; aHR, 1.094, 95% CI, 1.034-1.158 in women drinking alcohol ≥40 g/day, compared with non-drinking women). In both sexes, an inverse association of alcohol intake with the annual eGFR decline and incident low eGFR was observed. This study observed a beneficial effect of moderate alcohol intake on incident proteinuria in men and a protective effect of alcohol intake of any amount on the annual eGFR decline and incident low eGFR in both sexes. The long-term implications of these observations need to be elucidated with future studies.
为了评估饮酒与慢性肾脏病指标之间的关联,以及这种关联在性别方面的差异,我们分析了 14190878 名成年人的健康筛查数据,这些成年人至少接受了 3 次健康筛查,且基线时肾小球滤过率(eGFR)≥60mL/min/1.73m2,且尿蛋白正常。eGFR 通过慢性肾脏病流行病学合作方程计算。蛋白尿定义为≥1+尿蛋白试纸法阳性,低 eGFR 定义为<60mL/min/1.73m2。采用扩展 Cox 模型,以饮酒水平为时间变化的决定因素,采用广义线性模型分析 eGFR 的年变化,来分析蛋白尿和低 eGFR 的发病风险。在男性中,观察到饮酒与蛋白尿发病之间存在 J 形关联(饮酒<10g/天的男性调整危险比[aHR]为 0.961,95%置信区间[CI]为 0.953-0.970;饮酒≥40g/天的男性 aHR 为 1.139,95%CI 为 1.123-1.154,与不饮酒的男性相比),而在女性中则存在正相关(饮酒<10g/天的女性 aHR 为 1.034,95%CI 为 1.023-1.044;饮酒≥40g/天的女性 aHR 为 1.094,95%CI 为 1.034-1.158,与不饮酒的女性相比)。在两性中,饮酒与 eGFR 年下降和蛋白尿发病之间均呈负相关。本研究观察到,在男性中,适量饮酒对蛋白尿发病有有益影响,而在两性中,任何量的饮酒对 eGFR 年下降和低 eGFR 发病均有保护作用。需要通过未来的研究阐明这些观察结果的长期意义。