健康人群中eGFR不是颈动脉内中膜厚度的危险因素  

Lack of Independent Relationship Between Ageing-related Decline in Kidney Function and Carotid Intima-media Thickness in Healthy Individuals

作　　者：张银平 张伟光[1] 曹聃 聂飒飒 宋康康 贾林沛 刘晓敏[1] 孙雪峰[1] 陈香美[1] 

机构地区：[1]解放军总医院肾病科肾脏疾病国家重点实验室暨慢性肾病国家临床医学研究中心,北京100853

出　　处：《中国中西医结合肾病杂志》2017年第5期397-400,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家"973"项目(No.2013CB530800)

摘　　要：目的:探讨健康人群中伴随增龄的肾功能改变与颈动脉内中膜厚度关系。方法:随机抽取北京市10个社区,按入选标准筛选健康居民1 112例,采用CKD-EPI公式估算肾小球滤过率(e GFR),超声检测颈动脉内中膜厚度(CIMT)。分为动脉壁增厚组(CIMT≥0.9 mm)与正常组(CIMT<0.9 mm);以及年轻组(<65岁)和老年组(≥65岁)。结果:与年轻组比较,老年组收缩压明显升高,e GFR水平明显降低;CIMT明显增厚,颈动脉斑块比例明显增加。与CIMT正常组比较,CIMT增厚组年龄、BMI、SBP、DBP、PP、FBG、TC、TG、LDL、HDL、Scr、BUN及UA水平明显升高,Alb和e GFR水平明显降低。单因素相关分析结果显示CIMT与年龄SBP、DBP、PP、FBG及BUN呈明显正相关,与e GFR呈明显负相关。非条件Logistic回归分析显示,年龄、SBP、FBG、Alb是CIMT增厚的独立危险因素,未发现e GFR与CIMT的增厚独立相关。结论:北京健康居民中,增龄性e GFR减退与CIMT增厚未见独立相关;更严格的血压、血糖控制,更好的营养状态可能对于防治健康人群动脉硬化更为重要。Objective：To explore the relationship between age -related changes in kidney function and carotid intimamedia thickness （CIMT） in healthy individuals. Methods： 10 communities were enrolled by a random cluster sampling method, a total of 1 112 participants satisfied the inclusion criteria and participated in this study finally. The estimated GFR（eGFR） was calculated using the CKD - EPI equation （ chronic kidney disease epidemiology collaboration ）. The CIMT was analysed using M - mode ultrasonography. 1 112 participants were assigned into two groups based on their CIMT values （ one group with CIMT 〈 0.9 mm and the other group with CIMT ≥0.9 mm） and based on their age （one group with age 〈 65 years and the other group with age ≥65 years）, respectively. Results：According to age groups ,SBP,CIMT and presence of carotid plaque increased with ageing , eGFR deseased with ageing. According to CIMT groups, age, BMI, SBP, DBP, PP, FBG ,TC, TG, LDL, HDL, Scr ~ BUN and UA were signitlcanfly higher in subjects with higher CIMT, however, ALB and eGFR were significantly lower in subjects with higher CIMT. The Pearson＇s analyze showed that a significant positive association of CIMT with age,SBP,DBP,PP,FBG and BUN, however a negative association of CIMT with eGFR. The regression analysis showed CIMT was independently associated with age,SBP,FBG and ALB. The regression analysis failed to find that eGFR was independently associated with CIMT. Conclusion：There is no independent relationship between ageing - related decline in kidney function and CIMT in a population with normal kidney function in Beijing. We suggested a better control of blood pressure ,blood sugar and better nourishment state may be beneficial to the prevention and cure of arteriosclerosis in healthy individuals.

关 键 词：健康人 增龄 颈动脉内中膜厚度 肾功能 

分 类 号：R692[医药卫生—泌尿科学]