正常或轻度肾功能受损社区居民肾小球滤过率与动脉硬化的相关性  

Correlation between glomerular filtration rate and arteriosclerosis in community residents with normal or mildly impaired kidney function

作　　者：边素艳[1] 叶平[1] 盛莉[1] 骆雷鸣[1] 肖铁卉[1] 祁莉萍[1] 吴红梅[1] 肖文凯[1] 段留法[1] 

机构地区：[1]解放军总医院老年心血管二科,北京100853

出　　处：《军医进修学院学报》2010年第6期532-534,537,共4页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的横断面调查正常或轻度受损社区居民估测的肾小球滤过率(eGFR)及传统心血管危险因素与脉搏波速度(PWV)的关系。方法北京4个社区入选2285名18-96岁居民,平均年龄51±16岁,用问卷调查方法采集病史,自动示波测量仪检测PWV,同期化验血脂、肌酐、尿酸、血糖等指标,简化的MDRD公式估测肾小球滤过率(eGFR)。结果随着eGFR的下降,年龄、脉压、肌酐、餐后2h血糖、颈股PWV(cfPWV)均显著增高(P<0.001),但颈桡PWV(crPWV)组间比较无统计学意义(P=0.672)。整体人群中,cfPWV(r=-0.353,P<0.001)、颈踝PWV(caPWV,r=-0.167,P<0.001)与eGFR呈显著负相关,而crPWV与eGFR无相关关系(r=-0.033,P=0.115);经校正性别、年龄和收缩压后,仅cfPWV与eGFR呈微弱负相关(r=-0.047,P=0.026)。逐步回归显示,eGFR降低是女性cfPWV增高的独立危险因素(R2=0.495,P<0.001),而男性eGFR对cfPWV无显著影响。结论肾小球滤过率降低是女性肾功能正常或轻度减退人群动脉僵硬度增加的独立危险因素,主要引起中心动脉僵硬度的增加,与外周动脉硬化无明显关系。Objective To investigate the correlation of pulse wave velocity（PWV）with estimated glomerular filtration rate（eGFR）and traditional cardiovascular risk factors in community residents with normal or mildly impaired kidney function.Methods A total of 2 285 community residents,at the age of 51±16 years,from 4 different communities in Beijing,were randomly recruited in this cross-sectional investigation.Questionnaire was used to collect their medical history.Their PWV was detected by oscillometry.Laboratory tests were performed to detect their basal biochemical parameters including serum glucose,uric acid,lipid,and creatinine.GFR was estimated following the modified diet in renal disease（MDRD）equation.Results The parameters including age,pulse pressure,serum creatinine,2h postprandial serum glucose,cfPWV,significantly increased with the decreasing eGFR（P0.001）.However,no difference was found in crPWV between different groups（P=0.672）.Decreased eGFR was independently associated with increased cfPWV（r=-0.353,P0.001）and caPWV（r=-0.167,P0.001）was negatively correlated with eGFR,while crPWV（r=-0.033,P=0.115）was not correlated with eGFR.After adjustment for gender,age and systolic blood pressure,cfPWV showed a weak correlation with eGFR（r=-0.047,P=0.026）.Multiple stepwise regression analysis revealed that decreased eGFR was an independent factor for increased cfPWV in women but had no remarkable effect on cfPWV in men.Conclusion Decreased eGFR is an independent factor for arteriosclerosis in women with normal or mildly impaired kidney function,leading to rigidity of central artery but not of peripheral arteries.

关 键 词：动脉硬化 脉搏波速度 肾小球滤过率 横断面研究 

分 类 号：R543[医药卫生—心血管疾病]