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在一般人群中,血压和高尿酸血症与蛋白尿和肾功能降低有关。

Association of blood pressure and hyperuricemia with proteinuria and reduced renal function in the general population.

机构信息

Yuuaikai Tomishiro Central Hospital, Tomigusuku, Japan.

Dialysis Unit, University of the Ryukyus Hospital, Nishihara, Japan.

出版信息

Hypertens Res. 2023 Jul;46(7):1662-1672. doi: 10.1038/s41440-023-01250-w. Epub 2023 Mar 29.

Abstract

This study aimed to investigate the effect of hyperuricemia (HU) on the association of systolic blood pressure (SBP) with the prevalence of proteinuria and low estimated glomerular filtration rate (eGFR) in the general population. This cross-sectional study enrolled 24,728 Japanese individuals (11,137 men and 13,591 women) who underwent health checkups in 2010. The prevalence of proteinuria and low eGFR (< 60 mL/min/1.73 m) among participants classified according to serum uric acid levels and SBP was compared. HU was defined as serum uric acid levels higher than the 75th percentile in male and female participants (> 7.2 and > 5.4 mg/dL, respectively). The odds ratio (OR) for proteinuria increased with elevated SBP. This trend was significantly evident in participants with HU. Moreover, there was an interactive effect of SBP and HU on the prevalence of proteinuria in the male (P = 0.04) and female (P = 0.04) participants. Next, we evaluated the OR for low eGFR (< 60 mL/min/1.73 m) with and without proteinuria based on the presence of HU. The multivariate analysis revealed that the OR for low eGFR with proteinuria increased with elevated SBP, but that for low eGFR without proteinuria decreased. These trends of OR tended to be prevalent among those with HU. The association between SBP and the prevalence of proteinuria was more pronounced in participants with HU. However, the association between SBP and decreased renal function with and without proteinuria might be different regardless of HU.

摘要

本研究旨在探讨高尿酸血症 (HU) 对收缩压 (SBP) 与蛋白尿和低估计肾小球滤过率 (eGFR) 患病率之间关联的影响。这项横断面研究纳入了 2010 年接受健康检查的 24728 名日本个体(男性 11137 名,女性 13591 名)。根据血清尿酸水平和 SBP 将参与者进行分类,比较蛋白尿和低 eGFR(<60mL/min/1.73m)的患病率。HU 定义为男性和女性参与者中血清尿酸水平高于第 75 百分位数 (>7.2 和>5.4mg/dL)。蛋白尿的比值比 (OR) 随 SBP 的升高而增加。这种趋势在 HU 患者中更为明显。此外,SBP 和 HU 对男性(P=0.04)和女性(P=0.04)参与者蛋白尿患病率存在交互作用。接下来,我们评估了 HU 存在时有无蛋白尿的情况下,低 eGFR(<60mL/min/1.73m)的 OR。多变量分析显示,伴有蛋白尿的低 eGFR 的 OR 随 SBP 的升高而增加,而不伴有蛋白尿的低 eGFR 的 OR 则降低。这些 OR 的趋势在 HU 患者中更为普遍。SBP 与蛋白尿患病率之间的关联在 HU 患者中更为明显。然而,无论 HU 如何,SBP 与蛋白尿和无蛋白尿的肾功能下降之间的关联可能不同。

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