Department of Nephrology, Zhongshan Hospital, Fudan University, No.180 Fenglin Road, Shanghai, 200032, China.
Shanghai Medical Center of Kidney, Shanghai, China.
Int Urol Nephrol. 2024 Jul;56(7):2325-2336. doi: 10.1007/s11255-023-03916-3. Epub 2024 Feb 17.
The roles of metabolic indices in predicting chronic kidney disease (CKD) were lacking. This study aimed to examine the concomitant impact of metabolic and novel anthropometric indices on incident CKD in the Chinese populations.
This prospective cohort study included 1825 males and 2218 females aged between 45 and 85 years, derived from the ongoing prospectively cohort of China Health and Retirement Longitudinal Study (CHARLS), from 2011 to 2015. The outcome was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m.
During the 5-years follow-up period, 3.0% (55/1825) of males and 4.1% (90/2218) of the females developed CKD. After multivariable adjustment, elevated triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C), serum uric acid (sUA), elevated visceral fat index (VFI), elevated body shape index (BSI) and elevated body roundness index (BRI) in males, and sUA, and BRI in females were the independent predictors for CKD. Composite scores, composed of sUA, history of cardiovascular disease (CVD), waist circumstance (WC), HDL-C, and BRI in males and sUA, hypertension, and BRI in females were constructed that could accurately predict CKD.
Our study found that elevated levels of TG, sUA, BSI, BRI, and diminished HDL in males and elevated levels of sUA, and BRI in females, are indicative of the incident CKD. The composite score, integrating a history of disease, metabolic indices, and noval anthropometric indices, could accurately differentiate individuals with and without incident CKD, proving useful for CKD care and management.
代谢指数在预测慢性肾脏病(CKD)方面的作用尚不清楚。本研究旨在探讨代谢和新型人体测量学指标对中国人群发生 CKD 的共同影响。
本前瞻性队列研究纳入了 2011 年至 2015 年来自中国健康与退休纵向研究(CHARLS)的 1825 名男性和 2218 名年龄在 45 至 85 岁之间的女性。结局定义为估算肾小球滤过率(eGFR)<60 mL/min/1.73 m。
在 5 年的随访期间,1825 名男性中有 3.0%(55/1825),2218 名女性中有 4.1%(90/2218)发生 CKD。经多变量调整后,男性中升高的甘油三酯(TG)、低高密度脂蛋白胆固醇(HDL-C)、血清尿酸(sUA)、升高的内脏脂肪指数(VFI)、升高的体型指数(BSI)和升高的身体圆度指数(BRI),以及女性中的 sUA 和 BRI 是 CKD 的独立预测因素。在男性中构建了由 sUA、心血管疾病(CVD)史、腰围(WC)、HDL-C 和 BRI 组成的复合评分,在女性中构建了由 sUA、高血压和 BRI 组成的复合评分,这些评分可以准确预测 CKD。
本研究发现,男性中 TG、sUA、BSI、BRI 水平升高和 HDL-C 水平降低,女性中 sUA 和 BRI 水平升高,均提示发生 CKD。综合疾病史、代谢指标和新型人体测量学指标的复合评分,可准确区分有无 CKD 事件的个体,有助于 CKD 的护理和管理。