残余胆固醇与亚临床肾损伤发生风险的相关性分析  

Association between residual cholesterol and the risk of subclinical renal damage

作　　者：张玺 牛泽家馨 胡桂霖 杜鸣飞 邹婷 张晓玉 王兰 褚超[1] 廖月圆 马琼[1] 王丹[1] 王科科 贾昊 陈晨[1] 严瑜 孙月 郭统帅[1] 张婕 高卫华[4] 满子悦 高可 罗文婧 牟建军[1] 汪洋[1,5] ZHANG Xi;NIU Zejiaxin;HU Guilin;DU Mingfei;ZOU Ting;ZHANG Xiaoyu;WANG Lan;CHU Chao;LIAO Yueyuan;MA Qiong;WANG Dan;WANG Keke;JIA Hao;CHEN Chen;YAN Yu;SUN Yue;GUO Tongshuai;ZHANG Jie;GAO Weihua;MAN Ziyue;GAO Ke;LUO Wenjing;MU Jianjun;WANG Yang(Department of Cardiovascular Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Cardiology,Xi’an International Medical Center Hospital,Xi’an 710100;Department of Cardiology,Xi’an People’s Hospital,Xi’an 710004;Department of Cardiology,Xi’an No.1 Hospital,Xi’an 710002;Global Health Institute,Xi’an Jiaotong University,Xi’an 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]西安国际医学中心医院心内科,陕西西安710100 [3]西安市人民医院心内科,陕西西安710004 [4]西安市第一医院心内科,陕西西安710002 [5]西安交通大学全球健康研究院,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第1期6-13,共8页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.81600327,No.81870319,No.82070437);陕西省自然科学基金项目(No.2021JM-257,No.2021JM-588);西安交通大学第一附属医院院基金(No.2019QN-06、No.2021ZXY-14)项目;西安交通大学第一附属医院临床研究项目(No.XJTU1AF-CRF-2021-021,No.XJTU1AF-CRF-2019-004)。

摘　　要：目的血脂异常与心血管疾病、代谢性疾病和终末期肾病密切相关。本研究旨在探讨残余胆固醇与亚临床肾损伤(SRD)发生风险的关系。方法基于既往建立的“汉中儿童青少年高血压研究队列”2017年的随访数据,根据估算肾小球滤过率(eGFR)和尿白蛋白肌酐比(uACR),将2342名受试者分为SRD组和非SRD组。采用多元线性回归和Logistic回归方法分析残余胆固醇与eGFR、uACR及SRD发生风险的关系。结果残余胆固醇与uACR呈正相关(r=0.081,P<0.001),而与eGFR呈负相关(r=-0.091,P<0.001)。多元线性回归分析显示,在校正性别、年龄、吸烟、饮酒、运动、体质指数、高血压、糖尿病、血尿酸等混杂因素后,残余胆固醇是uACR(β=0.075,P<0.001)和eGFR(β=-0.027,P<0.001)的影响因素。多元Logistic回归分析显示,在校正多种混杂因素后,残余胆固醇与SRD发生风险存在相关性[OR(95%CI)=1.387(1.113~1.728),P<0.001]。进一步亚组分析显示残余胆固醇与女性发生SRD风险显著相关,与男性无关。结论残余胆固醇是SRD发生风险的影响因素,且存在性别差异。Objective Dyslipidemia has shown to be associated with cardiovascular,metabolic and renal diseases.This study aimed to investigate the association between residual cholesterol and the risk of subclinical renal damage(SRD).Methods A total of 2342 participants were recruited from the previously established Hanzhong Adolescent Hypertension Study cohort.According to estimated glomerular filtration rate(eGFR)and urinary albumin-to-creatine ratio(uACR),the subjects were divided into SRD group and non-SRD group.The associations of residual cholesterol with eGFR,uACR,and the risk of SRD were analyzed by multiple linear and Logistic regression analyses.Results Residual cholesterol was positively correlated with uACR(r=0.081,P<0.001)but negatively correlated with eGFR(r=-0.091,P<0.001).Multiple linear regression analysis revealed that residual cholesterol was an influencing factor of uACR(β=0.075,P<0.001)and eGFR(β=-0.027,P<0.001)after adjustment for gender,age,smoke,alcohol,exercise,BMI,hypertension,diabetes and serum uric acid.In addition,Logistic regression analysis revealed that residual cholesterol was significantly associated with the risk of SRD independently of potential confounders[OR(95%CI)=1.387(1.113-1.728),P<0.001].Further subgroup analysis showed that residual cholesterol was significantly associated with the risk of SRD in women but not in men.Conclusion Residual cholesterol is a contributing factor in the risk of subclinical renal damage with gender-specific association.

关 键 词：残余胆固醇 亚临床肾损伤 估算肾小球滤过率 尿白蛋白肌酐比 

分 类 号：R541.3[医药卫生—心血管疾病]