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慢性乙型肝炎患者慢性肾脏病的危险因素:一项基于中国医院的病例对照研究

Risk Factors of Chronic Kidney Disease in Chronic Hepatitis B: A Hospital-based Case-control Study from China.

作者信息

Liu Yunqi, Wang Ximei, Xu Fuping, Li Dengren, Yang Huimin, Sun Nan, Fan Yu-Chen, Yang Xiangdong

机构信息

Department of Nephropathy, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Department of Nephropathy, Binzhou Medical University Hospital, Binzhou, Shandong, China.

出版信息

J Clin Transl Hepatol. 2022 Apr 28;10(2):238-246. doi: 10.14218/JCTH.2021.00082. Epub 2021 Jul 23.

Abstract

BACKGROUND AND AIMS

Chronic kidney disease (CKD) usually occurs during the chronic infection of hepatitis B virus (HBV). However, the risk factors of CKD in an HBV population have not been completely demonstrated. Our present study aimed to investigate the risk factors of CKD in chronic HBV infection using a hospital based cross-sectional study in the northern area of China.

METHODS

During January 2013 to December 2017, a total of 94 patients with CKD complicated by chronic HBV infection were consecutively enrolled in the study, as well as 548 age- and sex-matched hepatitis B patients without CKD who were enrolled as controls. Univariate and multivariate regression analyses were used to determine the effects of each variable after adjusting for cofounding factors.

RESULTS

Multivariate analysis showed that HBeAg-positive status (odds ratio [OR]=2.099, 95% CI 1.128-3.907), dyslipidemia (OR: 3.025, 95% CI 1.747-5.239), and hypertension (OR: 12.523, 95% CI 6.283-24.958) were independently associated with the incidence of CKD, while duration of HBV infection (≥240 months) (OR: 0.401, 95% CI 0.179-0.894), Log HBsAg (OR: 0.514, 95% CI 0.336-0.786), and coronary heart disease (OR: 0.078, 95% CI 0.008-0.768) were protective factors for the incidence of CKD. Duration of HBV infection, Log HBsAg, HBeAg-positive status and dyslipidemia remained the risk factors for CKD after adjusting for diabetes mellitus, hypertension, and coronary heart disease.

CONCLUSIONS

Duration of HBV infection, Log HBsAg, HBeAg-positive status and dyslipidemia contributed to the incidence of CKD during chronic HBV infection in a Chinese population.

摘要

背景与目的

慢性肾脏病(CKD)通常发生于慢性乙型肝炎病毒(HBV)感染期间。然而,HBV感染人群中CKD的危险因素尚未完全明确。我们目前的研究旨在通过一项基于医院的横断面研究,调查中国北方地区慢性HBV感染患者中CKD的危险因素。

方法

2013年1月至2017年12月期间,共有94例合并慢性HBV感染的CKD患者连续纳入本研究,以及548例年龄和性别匹配的无CKD的乙型肝炎患者作为对照。在调整混杂因素后,采用单因素和多因素回归分析来确定各变量的影响。

结果

多因素分析显示,HBeAg阳性状态(比值比[OR]=2.099,95%可信区间[CI] 1.128 - 3.907)、血脂异常(OR:3.025,95% CI 1.747 - 5.239)和高血压(OR:12.523,95% CI 6.283 - 24.958)与CKD的发生独立相关,而HBV感染持续时间(≥240个月)(OR:0.401,95% CI 0.179 - 0.894)、Log HBsAg(OR:0.514,95% CI 0.336 - 0.786)和冠心病(OR:0.078,95% CI 0.008 - 0.768)是CKD发生的保护因素。在调整糖尿病、高血压和冠心病后,HBV感染持续时间、Log HBsAg、HBeAg阳性状态和血脂异常仍然是CKD的危险因素。

结论

在中国人群慢性HBV感染期间,HBV感染持续时间、Log HBsAg、HBeAg阳性状态和血脂异常与CKD的发生有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8ed/9039709/9555661aa35c/JCTH-10-238-g001.jpg

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