中老年代谢综合征及其组分与肾小球滤过率相关性分析  

Metabolic syndrome and its components associated with glomerular filtration rate in middle-aged and elderly population

作　　者：胡颖[1] 时立新[2] 张巧[2] 彭年春[2] 徐淑静[2] 张淼[2] 

机构地区：[1]苏州大学第二附属医院内分泌代谢病科,215004 [2]贵州医科大学附属医院内分泌代谢病科,550004

出　　处：《中华内分泌代谢杂志》2017年第5期372-376,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：贵州省科技计划黔科合LH[2014]7107;贵州省省长基金临床应用课题专项研究黔省专合字（2012）100号;贵阳市科技计划项目筑科农合同（201303）25号

摘　　要：目的探讨中老年代谢综合征（MS）及其组分与肾小球滤过率（GFR）的相关关系。方法2010年5月至2010年8月在贵阳市宅吉社区整群随机抽取40岁以上居民10140人，纳入9894人，详细填写流行病学调查问卷．测量身高、体重、腰围及血压，采集血样测定肌酐、空腹血浆血糖（FPG）、餐后2h血浆血糖（PPG）、三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）和空腹胰岛素（FINS）。以国家胆固醇教育计划（NCEP）成人治疗专家组Ⅲ（ATPHI）并结合亚洲人群腰同的诊断标7伴诊断MS和评价肾功能。结果（1）MS组与非MS两组GFR〈60ml·min^-1·（1．73m^2）^-1。比率分别是3．0％和1．2％；年龄、体重指数、腰围、收缩压、舒张压、FPG、肌酐、LDL—C、TC、TG和GFR异常患病率MS组较非MS组升高，HDL—C、GFRMS组较非MS组降低（P〈0．05）。（2）校正各种影响因素后，MS组GFR异常的风险是非MS组的1．75倍（OR=1．75，95％CI1．29～2．37），高血压、高TG血症、低HDL-C血症、空腹血糖升高、肥胖患者合并慢性肾功能不全（CKD）的风险比分别是1．78、2．96、1．06、1．22。（3）随着MS组分的增加GFR异常的患病率增加，分别是0．56％、1．10％、1．50％、2．87％、3．23％，危险度分别为1．00、1．57、1．93、3．07、2．89。结论MS及其组分与GFR异常之间有显著的相关性，随着MS组分的增多患GFR异常风险增加。CKD的发生可能是MS中的多重不同危险因素共同作用的结果。Objective To explore the relationship between metabolic syndrome （MS） and glomerular filtration rate （GFR）. Methods A total of 10 140 adults aged 40 years and older inhabitants in Zhaiji community of Guiyang urban areas were investigated from May 2010 to August 2010 by adopting stratified cluster sampling method. The venous blood sample was drawn for the measurements of sermn creatinine （Cr） , fasting plasma glucose （FPG）, OGTF2hPG, fiasting insulin, triglyceride （TG）, total cholesterol（ TC ）, high-density lipoprotcin-cholesterol （ HDL-C）, low-density fipoprotein-cholesterol （ LDL-C ） , and fasting plasma insulin. The definition of MS in our study was modeled after the Adult Treatment Panel Ⅲ （ ATP-Ⅲ ）. Decreased GFR was defined as an estimated GFR〈 60ml·min^-1·（1.73m^2）^-1. Results The prevalence of GFR less than 60 ml·min^-1·（1.73m^2）^-1were3.0% and 1.2% in participants with and without MS, respectively. The multivariate-adjusted odds ratios [ 95% confidence interval（CI） ] of MS, which were independently associated with decreased GFR, were with elevated blood pressure, higher TG, lower HDL-C, and elevated FPG, their statistically odds ratios were 1.78, 2.96, 1.06, and 1.22, respectively. The prevalence of GFR decreased with the increase of MS components by 0.56% , 1.10% , 1.50% , 2.87% , 3.23% , and the odds ratios were 1.00, 1.57, 1.93,3.07, and 2.89, respectively. Conclusion With the increase of MS components the risk of GFR decline increased. The occmTence of chronic renal dysfunction （ CKD ） might integrate muhiple different risk factors of MS.

关 键 词：代谢综合征 肾小球滤过率 

分 类 号：R589[医药卫生—内分泌]