血浆同型半胱氨酸对 H 型高血压中国成年人慢性肾脏病的饱和效应：一项横断面研究。

Saturation Effects of Plasma Homocysteine on Chronic Kidney Disease in Chinese Adults With H-type Hypertension: A Cross-sectional Study.

机构信息

Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.

Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China; Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.

出版信息

J Ren Nutr. 2021 Sep;31(5):459-466. doi: 10.1053/j.jrn.2020.09.002. Epub 2020 Oct 31.

DOI:10.1053/j.jrn.2020.09.002

PMID:33131976

Abstract

OBJECTIVE

Data on the association between homocysteine (Hcy) and the risk of chronic kidney disease (CKD) in patients with H-type hypertension were limited. This study aimed to examine the relation of Hcy with the prevalence of CKD and estimated glomerular filtration rate (eGFR) among Chinese adults with H-type hypertension.

METHODS

A total of 12,873 Chinese adults with H-type hypertension aged 27-75 years were enrolled in the final analysis. Hcy concentrations were divided into 11 groups at 2 μmol/L interval. The outcome was CKD, defined as eGFR <60 mL/min/1.73 m.

RESULTS

The prevalence of CKD was 7.58%, and the mean Hcy was 17.58 ± 10.96 μmol/L. The smoothing curve indicated that with the increase of Hcy, the prevalence of CKD increases first and then flattens, eGFR decreases first and then flattens, which supports the L-shaped association of Hcy with the prevalence of CKD and eGFR. Moreover, we further found the inflection point of Hcy was 22 μmol/L. OR (95% CI) of risk of CKD was 1.31 (1.28, 1.35) on the left side of an inflection point and 1.00 (0.99, 1.01) on the right of an inflection point, β (95% CI) of eGFR was -1.58 (-1.65, -1.50) on the left side of an inflection point and 0.00 (-0.03, 0.03) on the right of an inflection point, respectively. Similar results were found in various subgroups.

CONCLUSIONS

Our study suggested saturation effects of Hcy on the prevalence of CKD and eGFR among Chinese patients with H-type hypertension.

摘要

目的

关于同型半胱氨酸（Hcy）与 H 型高血压患者慢性肾脏病（CKD）风险之间的关联，数据有限。本研究旨在研究 Hcy 与中国 H 型高血压成人 CKD 患病率和估算肾小球滤过率（eGFR）之间的关系。

方法

共纳入 12873 名年龄在 27-75 岁的 H 型高血压中国成年人进行最终分析。以 2μmol/L 为间隔将 Hcy 浓度分为 11 组。结局为 CKD，定义为 eGFR<60mL/min/1.73m。

结果

CKD 的患病率为 7.58%，平均 Hcy 为 17.58±10.96μmol/L。平滑曲线表明，随着 Hcy 的增加，CKD 的患病率先增加后趋于平稳，eGFR 先降低后趋于平稳，这支持了 Hcy 与 CKD 患病率和 eGFR 的“L”形关联。此外，我们还发现 Hcy 的拐点为 22μmol/L。拐点左侧 Hcy 的 OR（95%CI）为 1.31（1.28，1.35），右侧为 1.00（0.99，1.01）；拐点左侧 eGFR 的β（95%CI）为-1.58（-1.65，-1.50），右侧为 0.00（-0.03，0.03）。在各种亚组中均得到了相似的结果。