代谢综合征与中青年慢性肾脏病的相关性研究

Metabolic Syndrome in Young and Middle-aged Patients with CKD 3-4

目的 探讨慢性肾脏病（chronic kidney disease,CKD）3-4期的中青年患者代谢综合征的发生率、临床特点、危险因素,以及与CKD之间的关系.方法 选取2009年12月-2012年12月在我院肾内科住院的35-60岁的CKD 3-4期患者132例（CKD组）及同期来自心内科无CKD的140例对照者（对照组）为研究对象,对比分析两组代谢综合征的发生率及CKD合并代谢综合征和非代谢综合征患者的临床资料,采用多因素Logistic回归分析检验CKD的危险因素.结果 CKD组代谢综合征的发生率为25.8%（34例）,对照组为11.4%（16例）.代谢综合征组患者吸烟率、饮酒率、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、三酰甘油（TG）、血肌酐（Scr）、血尿酸（UA）及体质指数（BMI）均高于非代谢综合征组,高密度脂蛋白胆固醇（HDL-C）和估算肾小球滤过率（eGFR）低于非代谢综合征组（P＜0.05）.多因素Logistic回归分析显示BMI≥25 kg/m^2（OR=2.648,P=0.000 2）及FBG（OR=6.828,P=0.000 1）、UA（OR=2.711,P=0.002 1）、TG（OR=1.723,P=0.020 4）、血压（OR=1.531,P=0.001 3）升高是发生CKD的危险因素.结论 CKD 3-4期中青年患者中代谢综合征发生率高,吸烟、饮酒影响了代谢综合征的发生.代谢综合征组分肥胖及高血糖、高尿酸血症、高三酰甘油血症、高血压是发生CKD的危险因素.

Objective To investigate the prevalence, clinical features and risk factors of metabolic syndrome （MS） in young and middle - aged patients with CKD 3 -4, and the risk factors of CKD. Methods This study selected the clinical da- tas of 132 cases of young and middle -aged patients with CKD 3 -4 and 140 cases as normal control who were hospitalized in the Department of Nephrology of our hospital over the same period of December 2009 to December 2012 and were aged of 35 - 60 years old. Comparatively analyzed the incidence of MS between two groups, and these clinical datas of CKD patients with MS or nMS. Multivariate Logistic regression analysis was used to test the risk factors of CKD. Results The incidence of MS in the CKD patients and the control group was respectively of 25.8% （34 cases） and 11.4% （16 cases）. The smoking rate, drinking rate, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting blood glucose （FBG）, triglyceride （TG）, se- rum creatinine （Scr） , serum uric acid （UA） , BMI of CKD patients with metabolic syndrome group （ MS group） were signifi- cantly higher than those in the CKD patients without metabolic syndrome group （ nMS group ）, while the HDL and eGFR - MDRD of MS group were significantly lower than nMS group （P 〈 0. 05 ）. Multivariate Logistic regression analysis prompted BMI 〉/25 kg/m^2 （OR=2.648, P=0.0002）, the rise of FBG （OR=6.828, P=0.000 1）, UA （OR=2.711, P=0.002 1）, TG （ OR = 1. 723, P = 0. 020 4） and blood pressure （ OR = 1.531, P = 0. 001 3 ） were the risk factors of CKD. Conclusion The prevalence of metabolic syndrome in young and middle - aged patients with CKD 3 - 4 was high. Smoke and alcohol affect it. BMI≥25 kg/m^2, FBG, UA, TG and blood pressure were the risk factors of CKD.