中国中老年糖尿病群体肾功能不全的患病率研究  

Prevalence of renal insufficiency among middle-aged and older Chinese with diabetes

作　　者：高慧 吴雄酉 王侃 GAO Hui;WU Xiong-you;WANG Kan(Changning Center for Disease Control and Prevention,Shanghai 200050,China;不详)

机构地区：[1]上海市长宁区疾病预防控制中心,上海200050 [2]安徽省桐城市人民医院急诊科 [3]伊拉斯姆斯医学中心

出　　处：《现代预防医学》2023年第1期188-192,共5页Modern Preventive Medicine

摘　　要：目的探究我国中老年糖尿病人群肾功能不全的患病率,比较2012和2021版eGFR评估公式计算结果的差异。方法基于中国健康与养老追踪调查2015年的随访数据,包括问卷调查、体格检查和实验室检测等,分别根据CKD-EPIcr-cyst 2012和CKD-EPIcr-cyst 2021公式计算了中老年糖尿病群体肾功能不全的患病率,并比较二者间患病率的总体一致性和异质性。结果中国中老年群体糖尿病群体中,根据CKD-EPIcr-cyst 2012判定的肾功能不全患病率为7.2%(5.7%~8.7%),根据CKD-EPIcr-cyst 2021判定的肾功能不全患病率为5.9%(4.6%~7.2%),二者间的总体一致性为98.7%(98.0%~99.4%),总体异质性为1.3%(0.6%~2.0%)。与CKD-EPIcr-cyst 2021定义为肾功能不全的糖尿病患者相比,仅由CKD-EPIcr-cyst 2012判定的肾功能不全糖尿病患者较为年轻(t=2.009,P=0.045),且高密度脂蛋白水平较高(t=-2.471,P=0.014);但相较于被两种公式均定义为肾功能正常的糖尿病人群,仅由CKD-EPIcr-cyst 2012判定的肾功能不全组仍年龄较大(t=-11.538,P<0.001),血压水平偏高(收缩压:t=-2.944,P=0.004;舒张压:t=2.500,P=0.013),认知功能得分较低(t=3.151,P=0.002),日常活动受限较多(t=-4.221,P<0.001),且心血管疾病的现患率(χ^(2)=-2.274,P=0.024)和10年患病风险均较高(t=-2.720,P=0.007)。结论CKD-EPIcr-cyst 2021与CKD-EPIcr-cyst 2012之间的总体一致性高。Objective To estimate the prevalence of renal insufficiency(eGFR<60 ml·min-1·1.73m-2)for middle-aged and older Chinese(≥45 years old)with diabetes and to estimate the impact of using the updated CKD-EPI cr-cyst 2021 equations.Methods ata from the nationally representative China Health and Retirement Longitudinal Study wave 2015the concordance and discordance in the prevalence of renal insufficiency for middle-aged and older Chinese with diabetes.Results Among the middle-aged and older Chinese with diabetes,the prevalence of renal insufficiency defined by the CKD-EPIcr-cyst 2012 was 7.2%(5.7%-8.7%),5.9%(4.6%-7.2%)by the CKD-EPIcr-cyst 2021.The overall concordance and discordance 98.7%(98.0%-99.4%)and 1.3%(0.6%-2.0%),respectively.Compared to participants with renal insufficiency defined by CKD-EPIcr-cyst 2021,those with renal insufficiency defined by CKD-EPIcr-cyst 2012 only were younger(t=2.009,P=0.045)and had higher high-density lipoprotein levels(t=-2.471,P=0.014).However,compared to those defined by both formulas as having normal renal function,those with renal insufficiency defined by CKD-EPIcr-cyst 2012 only were still older(t=-11.538,P<0.001),had higher levels of blood pressure(systolic blood pressure:t=-2.944,P=0.004;diastolic blood pressure:t=2.500,P=0.013),had lower cognitive function scores(t=3.151,P=0.002),more likely to be limited during daily activity(t=-4.221,P<0.001)and had prevalent cardiovascular disease(χ^(2)=-2.274,P=0.024),and had higher 10-year cardiovascular risk scores(t=-2.720,P=0.007).Conclusion A high degree of concordance between the CKD-EPIcr-cyst 2012 and the CKD-EPIcr-cyst 2021 is found among middle-aged and older Chinese with diabetes.

关 键 词：中老年 糖尿病 肾功能不全 肾小球滤过率评估方程 患病率 

分 类 号：R587.1[医药卫生—内分泌]