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中国成年人中高甘油三酯腰围表型与尿白蛋白肌酐比值升高之间的关联:REACTION研究

Association Between Hypertriglyceridemic Waist Phenotype and Increased Urinary Albumin-Creatinine Ratio in Chinese Adults: The REACTION Study.

作者信息

Su Wanlu, Wang Jie, Mu Yiming

机构信息

Medicine School of Nankai University, No. 94 Weijin Road, Tianjin 300071, People's Republic of China.

Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Aug 21;13:2965-2974. doi: 10.2147/DMSO.S257736. eCollection 2020.

Abstract

PURPOSE

The hypertriglyceridemic waist (HTGW) phenotype can predict cardiovascular disease (CVD) risk. Additionally, strong evidence indicates that elevated urinary albumin-creatinine ratio (UACR) is associated with increased prevalence of CVD. However, few studies have explored the association between the HTGW phenotype and UACR.

PATIENTS AND METHODS

In this cross-sectional descriptive study, a total of 40,674 subjects (28,562 women and 12,112 men older than 40 years) were recruited from seven different geographic regional centres. The HTGW phenotype was defined as increased triglyceride levels (triglyceride ≥ 1.5 mmol/L for female and ≥2.0 mmol/L for male) and waist circumference (WC; WC ≥ 85 for female and WC ≥ 90 cm for male). Logistic regression analyses were performed to assess the relationship between UACR and the HTGW phenotype.

RESULTS

Subjects with the HTGW phenotype showed a more significant trend towards increased excretion of UACR [among all subjects, odds ratio (OR) = 1.303, 95% CI: 1.132-1.499, P < 0.001; among men, OR = 1.406, 95% CI: 1.057-1.870, P = 0.019; among women, OR = 1.268, 95% CI: 1.074-1.496, P = 0.005]. Furthermore, the stratified analysis showed that the OR for high-risk significantly increased in individuals in the HTGW group aged below 65 years, with 5.6 ≤ fasting blood glucose < 7.0 or 7.8 ≤ post-load blood glucose <11.1 mmol/L, 120 ≤ systolic blood pressure < 140 or 80 ≤ diastolic blood pressure < 90, 24 ≤ body mass index < 28 kg/m, and estimated globular filtration rate > 90 mL/min per 1.73 m.

CONCLUSION

This study has advanced the understanding of visceral obesity and our results supported the fact that the HTGW phenotype is associated with elevated UACR excretion among general Chinese adults.

摘要

目的

高甘油三酯性腰围(HTGW)表型可预测心血管疾病(CVD)风险。此外,有力证据表明,尿白蛋白肌酐比值(UACR)升高与CVD患病率增加相关。然而,很少有研究探讨HTGW表型与UACR之间的关联。

患者与方法

在这项横断面描述性研究中,从七个不同的地理区域中心招募了总共40674名受试者(28562名女性和12112名40岁以上男性)。HTGW表型定义为甘油三酯水平升高(女性甘油三酯≥1.5 mmol/L,男性≥2.0 mmol/L)和腰围(WC;女性WC≥85,男性WC≥90 cm)。进行逻辑回归分析以评估UACR与HTGW表型之间的关系。

结果

具有HTGW表型的受试者显示出UACR排泄增加的更显著趋势[在所有受试者中,比值比(OR)=1.303,95%置信区间:1.132 - 1.499,P < 0.001;在男性中,OR = 1.406,95%置信区间:1.057 - 1.870,P = 0.019;在女性中,OR = 1.268,95%置信区间:1.074 - 1.496,P = 0.005]。此外,分层分析表明,在65岁以下的HTGW组个体中,高风险的OR显著增加,这些个体的空腹血糖为5.6≤空腹血糖<7.0或7.8≤负荷后血糖<11.1 mmol/L,收缩压为120≤收缩压<140或舒张压为80≤舒张压<90,体重指数为24≤体重指数<28 kg/m²,且估计肾小球滤过率>90 mL/min/1.73 m²。

结论

本研究增进了对内脏肥胖的理解,我们的结果支持了HTGW表型与中国普通成年人UACR排泄升高相关这一事实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f03b/7457398/b5eddb487a5a/DMSO-13-2965-g0001.jpg

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