性别对肾功能增龄变化的影响研究  

Study on the influence of sex on age-related changes in renal function

作　　者：沈雪 魏璐 马尧 赵卫红 Shen Xue;Wei Lu;Ma Yao;Zhao Weihong(Division of Nephrology,Department of Geriatrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院老年肾科,南京210029

出　　处：《中华老年医学杂志》2022年第3期281-285,共5页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2018YFC2002100、2018YFC2002102);国家自然科学基金面上项目(82171585);江苏省干部保健课题(BJ17018);江苏省人民医院511工程(JSPH-511A-2018-5)。

摘　　要：目的评估性别对健康人群肾小球滤过率(GFR)增龄变化的影响。方法回顾性研究,共纳入健康研究对象36911例,其中男性占43.61%(16096例)、女性占56.39%(20815例),依年龄分为6个亚组(18~29岁、30~39岁、40~49岁、50~59岁、60~69岁和≥70岁),使用基于肌酐的全年龄阶段(FAS_(Scr))公式估算肾小球滤过率(eGFR),采用一般线性回归分析计算eGFR年下降率,男女性别间eGFR下降率的差异采用协方差分析评估,χ^(2)检验比较男女性别不同eGFR水平占比的差异。结果无论男女,随增龄体质指数(BMI)、收缩压、空腹血糖均逐渐上升,而舒张压呈先上升后下降的变化,但上述指标男性的均值普遍高于同龄女性。40岁前男女性eGFR水平相对平稳,但女性eGFR均值明显高于男性[(121.98±16.77)ml·min^(-1)·1.73 m^(-2)比(111.01±13.36)ml·min^(-1)·1.73 m^(-2),t=-53.793,P=0.000];40岁后男女性的eGFR均随增龄而下降,且70岁前女性eGFR的下降率显著高于男性。男性血尿素氮、血清肌酐、血尿酸均值普遍高于同龄女性,男女性尿素氮水平随增龄呈现上升趋势,女性Scr水平在40岁后也开始升高,而男性Scr水平未见随增龄上升的变化。结论增龄过程中多项指标存在性别差异,中青年女性的eGFR水平高于同龄男性,但女性的eGFR随增龄下降速度更快。Objective To evaluate the influence of sex on age-related changes in the glomerular filtration rate(GFR)in healthy individuals.Methods A retrospective survey was performed.A total of 36911 healthy subjects,of whom 43.61%(16096 cases)were men,were enrolled and divided into six age groups:18^(-2)9,30-39,40-49,50-59,60-69,and≥70 years old.The estimated glomerular filtration rate(eGFR)was evaluated by the full age spectrum(FAS)equation.General linear regression analysis was used to calculate the annual decline rate of eGFR,and differences between the sexes in the same age group were evaluated using analysis of covariance.The chi-square test was used to compare the proportions of subjects with different eGFR levels between the sexes.Results Regardless of sex,body mass index(BMI),systolic blood pressure(SBP)and fasting blood glucose(FBG)all increased gradually with age,while diastolic blood pressure(DBP)increased initially and then turned downward.The means of above results in men were generally higher than those in women of the same age.Before the age of 40,the levels of eGFR in men and women were relatively stable,with the mean eGFR in women higher than that in men[(121.98±16.77)ml·min^(-1)·1.73 m^(-2)vs.(111.01±13.36)ml·min^(-1)·1.73 m^(-2),t=-53.793,P=0.000];After the age of 40,eGFR decreased with age in both sexes,and the decline rate of eGFR in women was faster than that in men before the age of 70.Men had generally higher mean serum creatinine(Scr),blood urea nitrogen(BUN)and serum uric acid(UA)than women.With the increase of age,BUN levels increased gradually in men and women,but Scr levels started to increase after the age of 40 only in women and did not show a clear increase in men.Conclusions There are sex-related differences with aging,as measured with many parameters.Young and middle-aged women have significantly higher eGFR than men of the same age,but eGFR declines faster with aging in women.

关 键 词：肾小球滤过率 年龄因素 性别特性 

分 类 号：R692[医药卫生—泌尿科学]