Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Nutrients. 2022 Sep 28;14(19):4040. doi: 10.3390/nu14194040.
The objective of this study was to examine whether a higher number of ideal cardiovascular health (CVH) metrics are beneficial for lowering the risk of proteinuria. This is a retrospective cohort study with an average follow-up of 5 years. Participants between 21 and 75 years old and without a history of cardiovascular disease and proteinuria were enrolled. CVH metrics, including smoking, diet, physical activity, blood pressure, body mass index (BMI), cholesterol, and fasting glucose, were assessed by questionnaires, physical examination, and blood analysis. Proteinuria was assessed by dipstick measurement. During the follow-up period, 169,366 participants were enrolled, and 1481 subjects developed proteinuria. A higher number of ideal CVH metrics was related to a lower risk of proteinuria after adjustment. Among the components of CVH metrics, ideal blood pressure (HR = 0.33, 95% CI = 0.25-0.43), fasting glucose (HR = 0.17, 95% CI = 0.12-0.22), and BMI (HR = 0.20, 95% CI = 0.15-0.27) had beneficial effects on proteinuria. Despite no significant benefit of diet score, the corresponding lower sodium intake showed a lower risk of proteinuria (HR = 0.58, 95% CI = 0.43-0.79). Incident proteinuria was inversely related to the number of ideal CVH metrics. CVH metrics may be a predictor of proteinuria, and achieving a higher number of ideal scores should be recommended as a proteinuria prevention strategy.
本研究旨在探讨是否存在更多理想心血管健康 (CVH) 指标可降低蛋白尿风险。这是一项回顾性队列研究，平均随访时间为 5 年。研究纳入了年龄在 21 至 75 岁之间、无心血管疾病和蛋白尿病史的参与者。通过问卷、体格检查和血液分析评估 CVH 指标，包括吸烟、饮食、身体活动、血压、体重指数 (BMI)、胆固醇和空腹血糖。通过尿试纸检测蛋白尿。在随访期间，共纳入 169366 名参与者，其中 1481 名发生蛋白尿。经过调整后，更多的理想 CVH 指标与蛋白尿风险降低相关。在 CVH 指标的组成部分中，理想血压 (HR = 0.33, 95%CI = 0.25-0.43)、空腹血糖 (HR = 0.17, 95%CI = 0.12-0.22) 和 BMI (HR = 0.20, 95%CI = 0.15-0.27) 对蛋白尿具有有益作用。尽管饮食评分没有显著益处，但相应的低钠摄入量显示蛋白尿风险较低 (HR = 0.58, 95%CI = 0.43-0.79)。蛋白尿的发生与理想 CVH 指标的数量呈反比关系。CVH 指标可能是蛋白尿的预测指标，建议达到更高的理想评分，作为蛋白尿预防策略。
