中国居民糖尿病前期与肾小球高滤过状况的关联研究  

Association between prediabetes and glomerular hyperfiltration status in residents in China

作　　者：侯悦 张梅[1] 张笑[1] 赵振平[1] 李纯[1] 于梦婷 王丽敏[1] Hou Yue;Zhang Mei;Zhang Xiao;Zhao Zhenping;Li Chun;Yu Mengting;Wang Limin(Division of Chronic Disease and Risk Factor Surveillance,National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心慢病危险因素监测室,北京100050

出　　处：《中华流行病学杂志》2025年第1期18-25,共8页Chinese Journal of Epidemiology

基　　金：国家重点研发计划(2021YFC2500201)。

摘　　要：目的探讨我国居民糖尿病前期与肾小球高滤过状况的关联性。方法研究对象为2018年中国慢性病及危险因素监测中的非糖尿病人群。根据糖尿病前期的定义,将研究对象分为正常血糖组和糖尿病前期组,采用多因素logistic回归分析糖尿病前期分别与肾小球高滤过和肾小球滤过率下降风险的关联,采用限制性立方样条探讨不同血糖指标与肾小球高滤过风险的剂量-反应关系。结果筛选符合条件的18~74岁研究对象129735名,其中糖尿病前期45336名。调整混杂因素后,与正常血糖组相比,糖尿病前期组肾小球高滤过的OR值为1.26(95%CI:1.20~1.32),糖尿病前期与肾小球滤过率下降无关联(OR=1.03,95%CI:0.96~1.12)。年龄分层的结果表明,18~59岁人群中糖尿病前期组较正常血糖组肾小球高滤过风险增加28%(OR=1.28,95%CI:1.21~1.35),60~74岁老年人风险增加15%(OR=1.15,95%CI:1.05~1.25);女性(OR=1.38,95%CI:1.29~1.47)糖尿病前期肾小球高滤过风险高于男性(OR=1.14,95%CI:1.06~1.22);身体活动不足人群(OR=1.29,95%CI:1.22~1.36)糖尿病前期肾小球高滤过风险高于身体活动充足人群(OR=1.16,95%CI:1.04~1.29)。限制性立方样条结果显示,FPG、糖化血红蛋白与肾小球高滤过风险均呈U形关联;服糖后2 h血糖肾小球高滤过风险呈近似J形关联。结论我国居民糖尿病前期人群存在肾小球高滤过的风险,糖尿病前期与肾小球滤过率下降无关。在早期和可逆阶段控制高血糖,对防止肾小球高滤过进一步转变为低滤过并导致肾功能损伤具有重要意义。Objective To explore the association between pre-diabetes and glomerular hyperfiltration status in residents in China.MethodsThe study subjects were the non-diabetes population in China Chronic Disease and Risk Factor Surveillance in 2018.According to the definition of prediabetes,the study subjects were divided into normoglycemic and pre-diabetes groups,and multivariate factorial logistic regression model was used to analyze the association between prediabetes and the risk for glomerular hyperfiltration and glomerular filtration rate decline,respectively.Restricted cubic spline was used to explore the dose-response relationship between different glycemic indexes and the risk for glomerular hyperfiltration.ResultsA total of 129735 eligible study subjects aged 18 to 74 years were included,including 45336 persons with prediabetes.After adjusting for confounders,the OR for glomerular hyperfiltration in the prediabetes group was 1.26(95%CI:1.20-1.32)compared with the normoglycemic group,and prediabetes was not associated with decreased glomerular filtration rate(OR=1.03,95%CI:0.96-1.12).Age-stratified results showed a 28%increase of risk for glomerular hyperfiltration in prediabetes group compared with normoglycemic group in those aged 18-59 year(OR=1.28,95%CI:1.21-1.35),and a 15%increase of risk in old adults aged 60-74 years(OR=1.15,95%CI:1.05-1.25);the risk for glomerular hyperfiltration in women with prediabetes(OR=1.38,95%CI:1.29-1.47)was higher than that in men with prediabetes(OR=1.14,95%CI:1.06-1.22);and the risk for prediabetes glomerular hyperfiltration was higher in those with insufficient physical activity(OR=1.29,95%CI:1.22-1.36)than in those who were physically active(OR=1.16,95%CI:1.04-1.29).Restricted cubic spline results showed that fasting plasma glucose,glycosylated hemoglobin and glomerular hyperfiltration risk all showed U-shaped associations,and 2 hours blood glucose glomerular hyperfiltration risk after taking sugar showed an approximate J-shaped association.ConclusionsThe risk for glomerular h

关 键 词：糖尿病前期 肾小球高滤过 肾小球滤过率 

分 类 号：R692[医药卫生—泌尿科学] R587.2[医药卫生—外科学]