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在中国一个基于社区的人群中,代谢综合征与估算肾小球滤过率快速下降相关。

Metabolic Syndrome Is Associated With Rapid Estimated Glomerular Filtration Rate Decline In A Chinese Community-Based Population.

作者信息

Wu Zhongli, Jiang Yimeng, Jia Jia, He Danmei, Sun Pengfei, Li Jianping, Huo Yong, Fan Fangfang, Zhang Yan

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2019 Oct 11;12:2085-2093. doi: 10.2147/DMSO.S217326. eCollection 2019.

Abstract

PURPOSE

This study aimed to determine the relationship between the metabolic syndrome (MetS) and rapid estimated glomerular filtration rate (eGFR) decline in a Chinese community-based population.

PATIENTS AND METHODS

A total of 3108 participants were recruited between December 2011 and July 2014 from an observational study cohort designed for the study of atherosclerotic diseases in Beijing, China. The outcome was a rapid eGFR decline. Subgroup and interaction analyses were performed with respect to a number of covariates.

RESULTS

Over a median follow-up period of 2.34 (IQR: 2.29-2.41) years, the overall incidence of rapid eGFR decline was 7.24%. We found that the MetS was significantly associated with the risk of rapid eGFR decline (odds ratio [OR]=1.69, 95% confidence interval [CI]: 1.28-2.23, <0.001) in a model adjusted for age, sex, and eGFR, and this relationship remained significant after adjustment for smoking, drinking, and low-density lipoprotein-cholesterol (OR=1.78, 95% CI: 1.34-2.35, <0.001). Waist circumference (OR=1.38, 95% CI: 1.04-1.83, =0.027), triglycerides (OR=1.40, 95% CI: 1.05-1.86, =0.022), blood pressure (OR=2.05, 95% CI: 1.49-2.82, <0.001), and fasting plasma glucose (OR=2.12, 95% CI: 1.57-2.85, <0.001), but not high-density lipoprotein-cholesterol (OR=1.26, 95% CI: 0.94-1.69, =0.117), were positively associated with the risk of rapid eGFR decline. Similarly, an increase in the number of MetS components present was associated with an increase in the risk of rapid eGFR decline. Furthermore, this association was modified by smoking status (OR=3.78, 95% CI: 1.68-8.49, -interaction=0.030).

CONCLUSION

The MetS independently predicted rapid eGFR decline in a Chinese community-based cohort recruited for the study of atherosclerosis. The relationship between the MetS and the risk of rapid eGFR decline was modified by smoking status.

摘要

目的

本研究旨在确定中国社区人群中代谢综合征(MetS)与快速估算肾小球滤过率(eGFR)下降之间的关系。

患者与方法

2011年12月至2014年7月期间,从一项针对中国北京动脉粥样硬化疾病的观察性研究队列中招募了3108名参与者。研究结果为快速eGFR下降。针对多个协变量进行了亚组分析和交互分析。

结果

在中位随访期2.34(四分位间距:2.29 - 2.41)年期间,快速eGFR下降的总体发生率为7.24%。我们发现,在调整了年龄、性别和eGFR的模型中,MetS与快速eGFR下降风险显著相关(优势比[OR]=1.69,95%置信区间[CI]:1.28 - 2.23,P<0.001),在调整了吸烟、饮酒和低密度脂蛋白胆固醇后,这种关系仍然显著(OR=1.78,95% CI:1.34 - 2.35,P<0.001)。腰围(OR=1.38,95% CI:1.04 - 1.83,P=0.027)、甘油三酯(OR=1.40,95% CI:1.05 - 1.86,P=0.022)、血压(OR=2.05,95% CI:1.49 - 2.82,P<0.001)和空腹血糖(OR=2.12,95% CI:1.57 - 2.85,P<0.001)与快速eGFR下降风险呈正相关,但高密度脂蛋白胆固醇(OR=1.26,95% CI:0.94 - 1.69,P=0.117)并非如此。同样,MetS组分数量的增加与快速eGFR下降风险的增加相关。此外,这种关联因吸烟状态而改变(OR=3.78,95% CI:1.68 - 8.49,交互作用P=0.030)。

结论

在为动脉粥样硬化研究招募的中国社区队列中,MetS独立预测了快速eGFR下降。MetS与快速eGFR下降风险之间的关系因吸烟状态而改变。

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