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高甘油三酯血症腰围表型与肾功能损害的关联:一项针对中国成年人群的横断面研究。

Association of hypertriglyceridemic waist phenotype with renal function impairment: a cross-sectional study in a population of Chinese adults.

作者信息

Qiu Yun, Zhao Qi, Wang Na, Yu Yuting, Wang Ruiping, Zhang Yue, Cui Shuheng, Zhu Meiying, Liu Xing, Jiang Yonggen, Zhao Genming

机构信息

Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, 200032 China.

Songjiang District Center for Disease Control and Prevention, Shanghai, 201600 China.

出版信息

Nutr Metab (Lond). 2020 Aug 5;17:63. doi: 10.1186/s12986-020-00483-7. eCollection 2020.

Abstract

BACKGROUND

Hypertriglyceridemic waist (HTGW) phenotype has been suggested as a risk factor for chronic kidney disease (CKD). However, there is limited evidence on the relationship of triglyceride waist phenotypes with estimated glomerular filtration rate (eGFR) status and severity. Our aim was to explore the associations of triglyceride waist phenotypes with reduced eGFR and various decreased eGFR stages among Chinese adults.

METHODS

A population-based, cross-sectional study was conducted among Chinese participants aged 20-74 years from June 2016 to December 2017 in Shanghai, China. An eGFR value below 60 mL/min/1.73 m was defined as decreased eGFR. HTGW phenotype was defined as triglyceride (TG) ≥1.7 mmol/L and a waist circumference (WC) of ≥90 cm for men and ≥ 80 cm for women. We examined the association of triglyceride waist phenotypes with decreased eGFR risk using the weighted logistic regression models.

RESULTS

A total of 31,296 adults were included in this study. Compared with normal TG level/normal WC (NTNW) phenotype, normal TG level/enlarged WC (NTGW) and elevated TG level/enlarged WC (HTGW) phenotypes were associated with the increased risk of decreased eGFR. Multivariable-adjusted ORs (95% CI) associated with NTGW, elevated TG level/normal WC (HTNW), and HTGW phenotypes were 1.75 (1.41-2.18), 1.29 (0.99-1.68), and 1.99 (1.54-2.58), respectively. These associations between triglyceride waist phenotypes and decreased eGFR risk remained across almost all the subgroups, including sex, age, BMI, T2DM, and hypertension. HTGW phenotype was consistently positively associated with the risk of mildly and moderately decreased eGFR, but not with severely decreased eGFR risk.

CONCLUSIONS

HTGW was consistently associated with the increased risk of decreased eGFR and various decreased eGFR stages, except for severely decreased eGFR. Further prospective studies are warranted to confirm our findings and to investigate the underlying biological mechanisms.

摘要

背景

高甘油三酯腰围(HTGW)表型被认为是慢性肾脏病(CKD)的一个危险因素。然而,关于甘油三酯腰围表型与估计肾小球滤过率(eGFR)状态及严重程度之间关系的证据有限。我们的目的是探讨中国成年人中甘油三酯腰围表型与eGFR降低及不同程度eGFR降低阶段之间的关联。

方法

2016年6月至2017年12月在中国上海对年龄在20 - 74岁的中国参与者进行了一项基于人群的横断面研究。eGFR值低于60 mL/min/1.73 m²被定义为eGFR降低。HTGW表型定义为男性甘油三酯(TG)≥1.7 mmol/L且腰围(WC)≥90 cm,女性TG≥1.7 mmol/L且WC≥80 cm。我们使用加权逻辑回归模型检验了甘油三酯腰围表型与eGFR降低风险之间的关联。

结果

本研究共纳入31296名成年人。与正常TG水平/正常WC(NTNW)表型相比,正常TG水平/增大WC(NTGW)和高TG水平/增大WC(HTGW)表型与eGFR降低风险增加相关。与NTGW、高TG水平/正常WC(HTNW)和HTGW表型相关的多变量调整后的比值比(95%可信区间)分别为1.75(1.41 - 2.18)、1.29(0.99 - 1.68)和1.99(1.54 - 2.58)。甘油三酯腰围表型与eGFR降低风险之间的这些关联在几乎所有亚组中都存在,包括性别、年龄、体重指数、2型糖尿病和高血压。HTGW表型与轻度和中度eGFR降低风险始终呈正相关,但与重度eGFR降低风险无关。

结论

除了重度eGFR降低外,HTGW与eGFR降低及不同程度eGFR降低阶段的风险增加始终相关。需要进一步的前瞻性研究来证实我们的发现并研究潜在的生物学机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/155a/7409629/168b1c3b81fa/12986_2020_483_Fig1_HTML.jpg

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