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中国老年人的年龄与估算肾小球滤过率:一项 2014 至 2020 年的队列研究。

Age and estimated glomerular filtration rate in Chinese older adults: a cohort study from 2014 to 2020.

机构信息

Department of Clinical Nutrition, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Health Management Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Public Health. 2024 Jun 25;12:1392903. doi: 10.3389/fpubh.2024.1392903. eCollection 2024.

Abstract

OBJECTIVES

This study aimed to fill the data gap of the course of renal function decline in old age and explore changes in renal function across different health states with increasing age.

METHODS

This observational, retrospective, single-center cohort study included 5,112 Chinese older adults (3,321 men and 1,791 women, range 60-104 years). The individual rate of estimated glomerular filtration rate (eGFR) decline was analyzed using linear mixed-effects model to account for repeated measures over the years.

RESULTS

The median age was 66 years, median BMI was 24.56 kg/m, and median eGFR was 89.86 mL/min.1.73 m. For every 1-year increase in age, women's eGFR decreased by 1.06 mL/min/1.73 m and men's by 0.91 mL/min/1.73 m. We observed greater age-related eGFR decline in men and women with high systolic blood pressure (SBP). Men with high triglyceride (TG), high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C), had greater age-related eGFR decline. In women, different BMI groups showed significant differences in age-related eGFR decline, with the highest decline in those with obesity. Additionally, participants with normal baseline eGFR had a faster age-related decline than those with low baseline eGFR.

CONCLUSION

The eGFR declined linearly with age in Chinese older adults, with women exhibiting a slightly faster decline than men. Both men and women should be cautious of SBP. Older adults with normal baseline renal function experienced a faster eGFR decline. Men with high TG, LDL-C, and low HDL-C levels, as well as obese women, should be vigilant in monitoring renal function.

摘要

目的

本研究旨在填补老年人肾功能下降过程的数据空白,并探讨随着年龄的增长,肾功能在不同健康状态下的变化。

方法

这是一项观察性、回顾性、单中心队列研究,纳入了 5112 名中国老年人(3321 名男性和 1791 名女性,年龄 60-104 岁)。使用线性混合效应模型分析个体估计肾小球滤过率(eGFR)下降率,以考虑多年来的重复测量。

结果

中位年龄为 66 岁,中位 BMI 为 24.56kg/m2,中位 eGFR 为 89.86mL/min·1.73m2。女性每增加 1 岁,eGFR 下降 1.06mL/min/1.73m2,男性下降 0.91mL/min/1.73m2。我们观察到,男性和女性的 eGFR 随着收缩压(SBP)的升高而下降更快。男性的甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)高和高密度脂蛋白胆固醇(HDL-C)低与年龄相关的 eGFR 下降有关。在女性中,不同 BMI 组的 eGFR 与年龄相关的下降存在显著差异,肥胖组下降最为明显。此外,基线 eGFR 正常的参与者比基线 eGFR 低的参与者的 eGFR 下降更快。

结论

中国老年人的 eGFR 随年龄呈线性下降,女性的下降速度略快于男性。男性和女性都应注意 SBP。基线肾功能正常的老年人 eGFR 下降更快。男性的 TG、LDL-C 高和 HDL-C 低,以及肥胖的女性,应警惕监测肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d201/11231386/1620922b6bd0/fpubh-12-1392903-g001.jpg

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