摘要
目的探讨中国中老年人群血尿酸(serum uric acid,SUA)水平与新发慢性肾脏病(chronic kidney disease,CKD)的相关性及性别差异。方法基于中国健康与养老追踪调查2011—2015年纵向随访数据,采用CKD-流行病学合作研究胱抑素C公式计算估算肾小球滤过率(estimated glomerular filtration rate,eGFR),纳入基线肾功能正常(eGFR≥60 mL·min^(-1)·1.72 m^(-2))的参与者4119例。2015年随访时eGFR<60 mL·min^(-1)·1.72 m^(-2)定义为新发CKD。采用Logistic回归分析比较不同性别参与者基线SUA水平对新发CKD的影响,限制性立方样条分析二者的剂量-反应关系。结果经过4年随访,127例参与者新发CKD,其中男性57例,女性70例。多因素Logistic回归分析结果显示,SUA水平升高与新发CKD发病风险独立相关(OR=1.532,P<0.001)。在不同性别亚组人群中分析SUA与新发CKD的关系,结果显示基线SUA每升高1 mg/dL,男性人群新发CKD风险增加33.6%(OR=1.336,P=0.012),女性人群新发CKD风险增加77.5%(OR=1.755,P<0.001)。限制性立方样条分析结果显示在男性和女性中SUA水平与新发CKD均呈线性正相关。参与者按照SUA四分位数分组(Q1~Q4),多因素校正后,女性人群Q3组(3.75 mg/dL<SUA≤4.43 mg/dL)、Q4组(SUA>4.43 mg/dL)与Q1组相比新发CKD风险显著增加(Q3组:OR=2.571,P=0.045;Q4组:OR=3.666,P=0.005)。结论SUA升高是中老年人群新发CKD的独立危险因素。女性SUA水平超过3.75 mg/dL与新发CKD风险增加相关。
Objective To investigate the correlation between serum uric acid(SUA)levels and incident chronic kidney disease(CKD)in middle-aged and elderly Chinese population and gender differences.Methods Based on the longitudinal survey data of China Health and Retirement Longitudinal Study from 2011 to 2015,the CKD-Epidemiology Collaboration cystatin C formula was used to estimate the glomerular filtration rate(eGFR),and 4119 participants with normal renal function(eGFR≥60 mL·min^(-1)·1.72 m^(-2))at baseline were included.Incident CKD was defined as eGFR<60 mL·min^(-1)·1.72 m^(-2)at the follow-up in 2015.Logistic regression analysis was used to analysis the association of SUA levels at baseline and incident CKD among different genders.Restricted cubic spline analysis was used to analyze the dose-response relationship.Results After 4-year follow-up,127 participants developed incident CKD,including 57 males and 70 females.Multivariate Logistic regression analysis showed that elevated SUA levels were independently associated with the risk of incident CKD(OR=1.532,P<0.001).For each 1 mg/dL increase in SUA,the risk of incident CKD increased by 33.6% in males(OR=1.336,P=0.012)and 77.5%in females(OR=1.755,P<0.001).Restricted cubic spline analysis showed a linear positive correlation between SUA levels and incident CKD in both males and females.Participants were divided into four groups according to SUA quartiles(Q1-Q4).Multivariate Logistic regression analysis indicated a significant increase in the risk of incident CKD in Q3 group(3.75 mg/dL<SUA≤4.43 mg/dL)and Q4 group(SUA>4.43 mg/dL)compared with Q1 group in females(Q3 group:OR=2.571,P=0.045;Q4 group:OR=3.666,P=0.005).Conclusion SUA is an independent risk factor for incident CKD in the middle-aged and elderly population.In females,serum uric acid levels exceeding 3.75 mg/dL are associated with an increased risk of incident CKD.
作者
闵青
张函
沈子妍
吕诗琦
朱诚
章晓燕
丁小强
MIN Qing;ZHANG Han;SHEN Zi-yan;LYU Shi-qi;ZHU Cheng;ZHANG Xiao-yan;DING Xiao-qiang(Department of Nephrology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Geriatrics,Kashi Prefecture Second People's Hospital,Kashi 844000,Xinjiang Uygur Autonomous Region,China)
出处
《复旦学报(医学版)》
北大核心
2025年第3期317-325,共9页
Fudan University Journal of Medical Sciences
基金
上海申康医院发展中心肾脏内科联盟项目(SHDC2202230)。
关键词
血尿酸(SUA)
慢性肾脏病(CKD)
性别差异
中老年人群
serum uric acid(SUA)
chronic kidney disease(CKD)
gender differences
middleaged and elderly population
