老年人血清铁与C反应蛋白的比值及25-羟基维生素D3与肾功能受损的关系研究  

Relationship of 25-hydroxyvitamin D3 and the ratio of serum iron to C-reactive protein with renal function impairment in the elderly

作　　者：刘思含 张静 Sihan Liu;Jing Zhang(Maternal and Child Health Hospital,Beijing 100069;Department of Oncology,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]丰台妇幼保健院,北京100069 [2]中国人民解放军总医院第一医学中心肿瘤内科,北京100853

出　　处：《中华肾病研究电子杂志》2024年第5期268-272,共5页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

摘　　要：目的探讨血清铁与C反应蛋白比值联合25-羟基维生素D3与老年人肾功能受损的关系。方法采用横断面研究设计,选取2017至2022年于我院健康体检的6512例老年人群,根据肾小球滤过率分为肾功能正常组和肾功能受损组[GFR<60 ml/(min·1.73 m2)]。采用限制性立方样条和多因素Logistic模型方法分析血清铁与C反应蛋白比值、25-羟基维生素D3与肾功能受损的相关性,接受者操作特性曲线评估其临床诊断价值。结果6512例老年人年龄(65.52±5.24)岁,男性占比64.3%,肾功能受损率42.5%。调整年龄、性别、身体质量指数、舒张压、总胆固醇、空腹血糖、同型半胱氨酸、叶酸等因素后,多因素Logistic回归分析结果显示,25-羟基维生素D3水平与肾功能受损的患病率呈负相关(P<0.05),而血清铁与C反应蛋白比值与肾功能受损的患病率亦呈负相关,后者在老年男性更为显著(P<0.05)。此外,血清铁与C反应蛋白比值联合25-羟基维生素D3诊断肾功能受损的曲线下面积为0.8295。结论老年人的血清铁与C反应蛋白比值和25-羟维生素D3,与肾功能受损的患病率呈负相关。Objective To investigate the relationship of 25-hydroxyvitamin D3 and the ratio of serum iron to C-reactive protein with renal function impairment in the elderly.Methods A cross-sectional study design was conducted,and 6512 people who underwent health examinations from 2017 to 2022 in our hospital were enrolled.Based on their glomerular filtration rate,the subjects were divided into the normal renal group and the abnormal renal function group(GFR<60 ml/min/1.73 m2).Restricted cubic splines and multivariate logistic model were used to analyze the relationship of 25-hydroxyvitamin D3 and the ratio of serum iron to C-reactive protein with the renal function impairment in the elderly.The recipient operating characteristic curve and decision curve analysis methods were used to evaluate their clinical diagnostic value.Results The average age of the 6512 elderly people was 65.52±5.24 years old,and the rate of renal function impairment was 42.5%,with the male accounting for 64.3%of the total.After adjusting for age,gender,body mass index,diastolic blood pressure,total cholesterol,fasting blood glucose,homocysteine,folic acid,and other factors,the results of multivariate logistic regression analysis showed that 25-hydroxyvitamin D3 level was negatively correlated with the prevalence of renal function impairment(P<0.05),and so was the ratio of serum iron to C-reactive protein,with the latter being more significant in the male(P<0.05).In addition,the area under the curve of 25-hydroxyvitamin D3 plus the ratio of serum iron to C-reactive protein was 0.8295 for diagnosis of the renal function impairment.Conclusion 25-hydroxyvitamin D3 and the ratio of serum iron to C-reactive protein were inversely correlated with the prevalence of renal function impairment in the elderly.

关 键 词：血清铁与C 反应蛋白比值 25-羟基维生素D3 肾功能受损 相关性 

分 类 号：R692[医药卫生—泌尿科学]