成年人脉搏波传导速度与肾功能之间的关系

Relationship between pulse wave velocity and renal function in an adult population

背景脉搏波传导速度(PWV)能一定程度上反映各种危险因素对血管的损伤,是心血管疾病危险率的独立预测因子。尿微量白蛋白和肌酐比值(MACR)与估算的肾小球滤过率(eGFR)可用于评估心血管病危险性。目的了解在成年人群中不同水平PWV的MACR、eGFR之间是否有差异以及它们之间是否存在关联。方法研究对象为整群抽样自愿参加河北省清河县高钾低钠盐试验的家庭成员,选取年龄40～75岁且资料完整的414人(男性160人,女性254人)作分析。抽取12h空腹静脉血。收集点尿,测定尿微量白蛋白、肌酐,计算MACR和eGFR。测定颈股动脉脉搏波传导速度(cfPWV)作为评估大动脉弹性功能的指标。结果根据cfPWV四分位把人群分组后,发现收缩压、舒张压和MACR均随着cfPWV水平升高而升高,eGFR随着cfPWV水平升高而降低;使用偏相关分析,控制年龄,发现cfPWV与收缩压、舒张压、平均动脉压(MAP)呈显著正相关(r分别为0.539、0.429、0.513,均P<0.01),cfPWV与eGFR呈负相关(r=-0.113,P<0.05);Spearman相关分析显示cfPWV与MACR正相关(rs值为0.157,P<0.01);线性回归模型表明在男性中排除了年龄、MAP、体质量指数的影响后,cfPWV仍与eGFR呈负相关(t=-2.046,P=0.042),与MACR呈正相关(t=2.232,P=0.027)。结论该成年人群血压、MACR与cfPWV之间存在正相关;cfPWV与eGFR呈负相关;在男性中cfPWV对MACR和eGFR可能有一定的预测作用。

Background Pulse wave velocity（PWV）as an independent predictor of cardiovascular disease partially reflected the vascular damage induced by various risk factors.Urinary microalbumin-to-creatinine ratio（MACR）and estimated glomerular filtration rate（eGFR）also played an important role in evaluating the risk of cardiovascular disease.Objective To investigate the relationships between carotid femoral pulse wave velocity（cfPWV）and MACR and eGFR in adults.Methods Four hundred and fourteen people（160 males,254 females）aged 40-75 years were selected from the population by clustering sampling,who participated in the baseline survey of the high potassium and low sodium salt trial conducted in Qinghe County,Hebei Province.12 h fasting blood and urine sample were collected and urinary microalbumin,creatinine were measured,then MACR,eGFR were calculated and cfPWV was assessed.Results Grouping the population by quartile of cfPWV,SBP,DBP and MACR elevated while eGFR decreased with the cfPWV increasing.Controlling for age,cfPWV was significantly positively correlated with SBP（r=0.539,P0.01）,DBP（r=0.429,P0.01）and mean arterial pressure（MAP）（r=0.513,P0.01）,meanwhile negatively related to eGFR（r=-0.113,P0.05）.Spearman nonparametric correlation analysis showed that cfPWV was significantly positively correlated with MACR（rs=0.157,P=0.001）.After adjusting for age,MAP,BMI,cfPWV still represented a negative correlation with eGFR（t=-2.046,P=0.042）and positive correlation with MACR（t=2.232,P=0.027）by linear regression model in men.Conclusion SBP,DBP and MACR significantly increased with the increasing of cfPWV,and the cfPWV showed a negative relation to eGFR.cfPWV may played an important role in evaluating MACR and eGFR of men in the region.