健康成人颈动脉斑块与肾功能增龄性下降的相关性  

Correlation of carotid plaque and age-related decline of renal function in healthy adults

作　　者：徐兰[1] 朱晶晶 赵雪兰[1] 赵霞娟[1] 任娇琦 周厚广[1] 张玉[1] Xu Lan;Zhu Jingjing;Zhao Xuelan;Zhao Xiajuan;Ren Jiaoqi;Zhou Houguang;Zhang Yu(Department of Geriatrics,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Clinical Research Unit,Shanghai Ninth People′s Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200125,China)

机构地区：[1]复旦大学附属华山医院老年医学科,上海200040 [2]上海交通大学医学院附属上海市第九人民医院临床研究室,上海200125

出　　处：《中华老年多器官疾病杂志》2025年第2期124-128,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：上海市卫生健康委员会面上项目(202140038);上海市卫生健康委员会中西医结合项目[ZY(2021-2023)-0207-01];科技部重点研发项目(2021YFE0111800);上海市临床重点专科(老年医学)项目(shslczdzk02802)。

摘　　要：目的探讨健康成人颈动脉斑块(CP)与肾功能增龄性下降的相关性。方法回顾性分析2016年1月至2019年1月在复旦大学附属华山医院老年科就诊及体检中心体检的449例受试者的临床资料,收集基线时CP、肾功能、血压、血糖、血脂等临床指标,并定期随访CP、肾功能,随访至2023年6月结束。根据入组时的年龄将患者分为年轻组(<60岁,n=286)和老年组(≥60岁,n=163);根据入组时是否存在CP,将受试者分为CP组(n=153)和非CP组(n=296);根据基线、随访后CP的变化情况将患者分为:组1(入组、随访后均没有斑块,n=244),组2(入组时没有,随访后新发斑块,n=52),组3(入组时有斑块,随访后斑块消失,n=26)和组4(入组、随访后均有斑块,n=127)。采用SPSS 26.0统计软件进行数据分析。根据数据类型,分别采用t检验、单因素方差分析、Mann-Whitney U检验或χ^(2)检验进行组间比较。采用logistic回归模型分析CP的影响因素。结果与年轻组相比,老年组的CP发生率增加(53.4%和25.2%);收缩压(SBP)、胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、尿酸(UA)及糖化血红蛋白(HbA1c)水平增高;血红蛋白(Hb)、基线肾小球滤过率(eGFR)水平降低,差异均有统计学意义(P<0.05)。与入组时无CP组相比,CP组的年龄、SBP、CHO、TG、LDL-C及UA水平增加;高密度脂蛋白胆固醇(HDL-C)及基线eGFR水平降低,差异均有统计学意义(P<0.05)。随访结束后,共有52例(11.6%)受试者新发CP,26例(5.6%)受试者CP消失。与组1相比,组2的基线eGFR水平降低,eGFR年均下降值增高;年龄、SBP、CHO、TG、LDL-C、UA、HbA1c水平增高,差异均有统计学意义(P<0.05)。与组3相比,组4的基线eGFR水平降低,eGFR年均下降值增高;年龄、SBP、CHO、LDL-C、UA水平也增高,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果提示,年龄(OR=5.098,95%CI 1.125~8.718;P<0.001)、SBP(OR=1.986,95%CI 1.019~3.289;P<0.001)、CHO(OR=1.804,95%Objective To investigate the correlation between carotid plaque(CP)and age-related decline of renal function in healthy individuals.Methods A retrospective cohort study was conducted on 449 subjects who visited Department of Geriatrics or took physical examination in Physical Examination Center in Huashan Hospital Affiliated to Fudan University from January 2016 to January 2019.Their clinical data,including CP,renal function,blood pressure,and blood glucose and lipids were collected at baseline,and CP and renal function were detected regularly during the follow-up,which was completed in June 2023.According to their age at baseline,they were divided into a young group(<60 years,n=286)and an elderly group(≥60 years,n=163).Subjects were divided into CP group(n=153)and non-CP group(n=296)according to whether CP was present at the time of enrollment.Based on the changes in CP at baseline and follow-up,they were assigned into four groups:Group 1(without CP at baseline or follow-up,n=244),Group 2(without CP at baseline but newly developed at follow-up,n=52),Group 3(with CP at baseline but disappeared CP at follow-up,n=26)and Group 4(with CP both at baseline and follow-up,n=127).SPSS statistics 26.0 was used for data analysis.Depending on data type,student′s t test,one-way analysis of variance,Mann-Whitney U test or Chi-square test was used for intergroup comparison.Logistic regression model was employed to identify the influencing factors for CP.Results The elderly group had significantly higher incidence of CP(53.4%vs 25.2%),increased systolic blood pressure(SBP),and elevated levels of cholesterol(CHO),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),uric acid(UA)and glycosylated hemoglobin A1c(HbA1c),but lower hemoglobin(Hb)level and decreased estimated glomerular filtration rate at baseline(baseline-eGFR),when compared with the young group(P<0.05).Advanced age,increased SBP,higher levels of CHO,TG,LDL-C and UA,but lower high-density lipoprotein-cholesterol(HDL-C)level and baseline-eGFR were observed in

关 键 词：颈动脉斑块 肾小球滤过率 增龄 

分 类 号：R543[医药卫生—心血管疾病]