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在血压正常、血糖正常且非肥胖的个体中,基线血清尿酸对慢性肾脏病的影响:一项健康体检队列研究。

The effect of baseline serum uric acid on chronic kidney disease in normotensive, normoglycemic, and non-obese individuals: A health checkup cohort study.

机构信息

Division of Nephrology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.

出版信息

PLoS One. 2021 Jan 27;16(1):e0244106. doi: 10.1371/journal.pone.0244106. eCollection 2021.

Abstract

INTRODUCTION

The independent role of serum uric acid (SUA) on kidney disease is controversial due to its association with metabolic syndrome. The objective of this study was to investigate the association of baseline SUA with development of chronic kidney disease and eGFR decline in normotensive, normoglycemic and non-obese individuals during follow up period.

MATERIALS AND METHODS

We included non-hypertensitive, non-diabetic, and non-obese 13,133 adults with estimated glomerular filtration rate (eGFR) ≥ 60ml/min/1.73m2 who had a voluntary health check-up during 2004-2017.

RESULTS

SUA was positively related to adjusted means of systolic blood pressure (SBP), triglyceride, body mass index, and body fat percent. SUA was inversely associated with high density lipoprotein HDL (P for trend ≤0.001). SUA was an independent risk factor for the development of diabetes, hypertension, and obesity. During 45.0 [24.0-76.0] months of median follow up, the highest quartiles of SUA showed significant risks of 30% eGFR decline compared than the lowest quartile (RR:3.701; 95% CI: 1.504-9.108). The highest quartile had a 2.2 fold (95% CI: 1.182-4.177) increase in risk for incident chronic kidney disease (CKD).

CONCLUSIONS

SUA is an independent risk factor for the development of diabetes, hypertension, and obesity in the healthy population. High SUA is associated with increased risk of CKD development and eGFR decline in participants with intact renal function.

摘要

简介

由于血清尿酸(SUA)与代谢综合征有关,因此其对肾脏疾病的独立作用存在争议。本研究的目的是在随访期间,调查基线 SUA 与正常血压、正常血糖和非肥胖人群中慢性肾脏病(CKD)的发展和 eGFR 下降的相关性。

材料和方法

我们纳入了 13133 名非高血压、非糖尿病和非肥胖的成年人,他们的估计肾小球滤过率(eGFR)≥60ml/min/1.73m2,并且在 2004-2017 年期间自愿进行了健康检查。

结果

SUA 与校正后的收缩压(SBP)、甘油三酯、体重指数和体脂百分比呈正相关。SUA 与高密度脂蛋白(HDL)呈负相关(趋势 P≤0.001)。SUA 是糖尿病、高血压和肥胖的独立危险因素。在中位随访 45.0[24.0-76.0]个月期间,SUA 最高四分位组与最低四分位组相比,eGFR 下降 30%的风险显著升高(RR:3.701;95%CI:1.504-9.108)。SUA 最高四分位组发生慢性肾脏病(CKD)的风险增加 2.2 倍(95%CI:1.182-4.177)。

结论

在健康人群中,SUA 是糖尿病、高血压和肥胖发展的独立危险因素。在肾功能正常的患者中,高 SUA 与 CKD 发展和 eGFR 下降的风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f60c/7840038/80d7c3c20c03/pone.0244106.g001.jpg

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