代谢综合征及其代谢因子与慢性肾损害相关性的临床研究

Clinical investigation of the correlation between metabolic syndrome and chronic kidney disease

目的探讨代谢综合征及其各组成因子与包括轻度肾损害在内的慢性肾损害的相关性。方法收集我院2003年1月至2003年12月心内科、肾内科和内分泌科符合人选标准的住院患者966例进行回顾性分析。按有、无慢性肾脏病(CKD)或轻度肾损害分组,比较代谢综合征各因素与慢性肾脏损害的关系。统计学处理包括单变量t检验、卡方检验和Logistic多因素回归分析。结果(1)CKD组的年龄、身体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高血糖、高血压和尿酸水平,冠心病、脑卒中的患病率均高于无CKD组,而高密度脂蛋白(HDL)水平明显低于元CKD组患者;(2)随着代谢综合征因子数量的增多,CKD发病率上升;(3)代谢综合征中各因子并存较各因子单独存在的CKD的危险性增加,与高血糖并存的频率最高;(4)BMI增加也是CKD的重要危险因素;(5)高血糖患者发生轻度肾损害的风险最大(优势比OR=7.698)。结论代谢综合征及其各组成因子是包括轻度肾损害在内的CKD的重要危险因素。随着代谢综合征因子的增多,CKD的危险也随之增加。除了高血糖和高血压,BMI增加也是其中重要的影响因子。

Objective To examine the correlation between the components of metabolic syndrome and chronic kidney disease (CKD) including minor renal dysfunction. Methods A retrospective study was performed with 966 patients who had been treated in our Cardiovasology Division, Nephrology Division and Endocrinology Division during 2003. According to the existence of CKD or not, and minor renal dysfunction, these patients were divided into different groups. The correlation between the components of metabolic syndrome and CKD was examined. T test, Chi square test and Logistic regression were used in the statistic analysis. Results Elevated levels of BMI, serum triglyceride, total cholesterol, uric acid, blood pressure , and plasma glucose were significantly correlated with increased prevalence of both chronic kidney disease and minor renal dysfunction. In addition, low HDL cholesterol level and abdominal obesity were significantly correlated with increased prevalence of chronic kidney disease. The risk increased as a result of a cumulative effect of the components of metabolic syndrome compared with the single component. Hyperglycemia was the most important risk factor for CKD (OR=7.698). Conclusions Metabolic syndrome and its components are important risk factors for CKD and minor renal dysfunction. The risk of chronic kidney disease elevates progressively as the number of components of the metabolic syndrome increases. In addition to hyperglycemia and hypertension, BMI>25 is also an important impact factor among various components.