肥胖高血压患者肾脏损害的性别差异  

Gender differences of kidney damage in obese patients with hypertension

作　　者：崔青 马锋[2] 曹丽菲 李敏[1] 陈慧[1] 栾慧 王萍[1] 田刚[1] CUI Qing;MA Feng;CAO Li-fei;LI Min;CHEN Hui;LUAN Hui;WANG Ping;TIAN Gang(Department of Cardiology,the First Affiliated Hospital of Xi'anJiaotong University,Xi'an Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061 [2]西安市中心医院心内科

出　　处：《中华高血压杂志》2019年第8期739-744,共6页Chinese Journal of Hypertension

基　　金：国家自然科学基金(81873513,81600574和30871042);陕西省科学技术研究发展计划重点项目(2018ZDXM-SF-049);陕西省科学技术研究发展计划国际科技合作与交流计划项目(2012 kw-40-01);陕西省科学技术研究发展计划自然科学基础研究计划项目(2014 JM2-8145);西安交通大学第一附属医院临床研究重点项目(XJTU1AF-CRF-2018-005)

摘　　要：目的探讨不同性别高血压患者肾损害的影响因素及观察不同性别肥胖高血压患者肾损害患病率的情况。方法入选原发性高血压患者695例,肥胖高血压患者311例(男性213例,女性98例),非肥胖高血压384例(男性205例,女性179例),以性别分层分析肥胖高血压患者和非肥胖高血压患者基线资料的差异,采用二分类Logistic回归分析肥胖高血压患者发生肾损害的性别差异。结果肥胖高血压组肾损害的患病率高于非肥胖高血压组(47.6%比22.7%);按性别分层分析发现女性肥胖高血压患者肾损害患病率高于男性肥胖高血压患者(55.1%比44.1%);女性肥胖高血压组年龄高于男性肥胖高血压组[(56.9±14.5)比(47.7±13.8)岁,P<0.001]。女性肥胖高血压组估算的肾小球滤过率(eGFR)低于男性肥胖高血压组[(95.1±25.4)比(102.8±25.4) mL/(min·1.73 m^2),P<0.05];男性肥胖高血压患者肾损害的发生风险较女性肥胖高血压患者低(OR=0.443,P=0.028)。结论女性肥胖高血压患者较男性肥胖高血压患者更易发生肾损害,且肾损害程度更严重。Objective To investigate the influencing factors of renal damage in hypertensive patients with different genders and to examine the prevalence of renal damages in obese hypertensive patients with different genders. Methods A total of 695 patients, including 384 non-obese-hypertension patients(male 205, female 179) and 311 obesity-hypertension patients(male 213, female 98) were enrolled in this study. Gender stratification was used to analyze the difference in baseline data between obese and non-obese hypertension patients. Binary Logistic regression was used to analyze the gender difference of renal damage in patients with obesity-hypertension. Results The prevalence of renal damage in obese-hypertension group was higher than that in non-obese-hypertension group(47.6% vs 22.7%). According to the gender stratification analysis, it was found that the prevalence of kidney damage in female obese patients with hypertension was higher than that in male obese patients with hypertension(55.1% vs 44.1%). The age of female obese-hypertension group was higher than that of male obese-hypertension group [(56.9±14.5)vs(47.7±13.8) years, P<0.001]. The estimated glomerular filtration rate(eGFR) of female obese-hypertension group was lower than that of male obese-hypertension group [(95.1±25.4) vs(102.8±25.4)mL/(min·1.73 m^2), P<0.05]. The risk of renal damage in male patients with obesity-hypertension was lower than that in female patients with obesity-hypertension(OR=0.443, P=0.028). Conclusion Female patients with obesity-hypertension are more prone to renal damage than male patients with obesity-hypertension and the degree of renal damage is severer.

关 键 词：肥胖高血压 性别差异 腰围 肾损害危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]