Duan J Y, Liu D W, Pan S K, Zhao Z H, Liu Z S
Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology of Zhengzhou University, Research Center for Kidney Disease of Henan Province, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2023 Feb 14;103(6):442-448. doi: 10.3760/cma.j.cn112137-20220914-01939.
To investigate the prevalence and risk factors of chronic kidney disease (CKD) in diabetic patients aged over 40 years in Henan province. A cross-sectional study was conducted. Diabetic patients aged over 40 years were recruited from four cities including Xuchang, Zhumadian, Luoyang and Zhengzhou in Henan Province between June 2015 and July 2019. Multivariate logistic regression analysis was employed to analyze the risk factors for CKD. A total of 3 067 diabetic patients were included in this study, including 1 238 males and 1 829 females. The mean age of all participants was (60.9±9.7) years and 85.8% (2 633/3 067) of them were living in rural areas. There were 1 155 participants who had CKD, and the overall prevalence of CKD was 37.7% (95%: 35.9%-39.4%). Compared with those without CKD, participants with CKD had older age [(61.4±10.3) vs (60.6±9.3) years], higher proportion of male patients (43.2% vs 38.7%), urban residents (19.4% vs 11.0%) and habitual drinkers (15.8% vs 12.7%), higher body mass index [(25.8±3.7) vs (25.4±3.6) kg/m), higher proportion of having hypertension (57.0% vs 37.2%), hyperuricemia (10.7% vs 7.1%) and dyslipidemia (46.5% vs 42.7%) (all <0.05). The prevalence of estimated glomerular filtration rate (eGFR) less than 60 ml·min·(1.73 m) and albuminuria was 4.9% (149/3 067) and 35.6% (1 092/3 067), respectively. Compared with rural participants [35.4% (95%: 34.4%-36.4%)], urban participants [51.6% (95%: 50.0%-53.2%)] had higher prevalence of CKD (<0.001). Multivariate logistic regression analysis showed that habitual drinker (=1.27, : 1.00-1.61, =0.046), moderate physical activities (=1.23, : 1.01-1.51, =0.039), having hypertension (=2.27, : 1.95-2.64, <0.001), dyslipidemia (=1.21, : 1.04-1.40, =0.012) and hyperuricemia (=1.56, : 1.21-2.02, =0.001) were independent risk factors for CKD. The prevalence of CKD is high in diabetic patients who aged over 40 years in Henan province. The associated factors for developing CKD include habitual drinking, heavier physical activities and having chronic diseases. Targeted prevention and intervention for associated factors would be beneficial for controlling CKD in middle and old aged diabetic patients.
为调查河南省40岁以上糖尿病患者慢性肾脏病(CKD)的患病率及危险因素。开展了一项横断面研究。2015年6月至2019年7月期间,从河南省许昌、驻马店、洛阳和郑州四个城市招募40岁以上的糖尿病患者。采用多因素logistic回归分析CKD的危险因素。本研究共纳入3067例糖尿病患者,其中男性1238例,女性1829例。所有参与者的平均年龄为(60.9±9.7)岁,85.8%(2633/3067)居住在农村地区。有1155例参与者患有CKD,CKD的总体患病率为37.7%(95%:35.9%-39.4%)。与未患CKD者相比,患CKD者年龄更大[(61.4±10.3)岁 vs (60.6±9.3)岁],男性患者比例更高(43.2% vs 38.7%)、城市居民比例更高(19.4% vs 11.0%)、经常饮酒者比例更高(15.8% vs 12.7%),体重指数更高[(25.8±3.7)kg/m vs (25.4±3.6)kg/m],患高血压比例更高(57.0% vs 37.2%)、高尿酸血症比例更高(10.7% vs 7.1%)、血脂异常比例更高(46.5% vs 42.7%)(均P<0.05)。估算肾小球滤过率(eGFR)<60 ml·min·(1.73 m)及蛋白尿的患病率分别为4.9%(149/3067)和35.6%(1092/3067)。与农村参与者[35.4%(95%:34.4%-36.4%)]相比,城市参与者[51.6%(95%:50.0%-53.2%)]的CKD患病率更高(P<0.001)。多因素logistic回归分析显示,经常饮酒者(OR=1.27,95%CI:1.00-1.61,P=0.046)、中等体力活动(OR=1.23,95%CI: