北京社区老年人群代谢综合征与慢性肾脏病的关系及性别差异研究

Association between metabolic syndrome and chronic kidney disease and sex specific difference among community elder population in Beijing

目的 探讨社区老年人群MS与慢性肾脏病（CKD）的关系及其性别差异.方法 2009年9月至2010年6月采用两阶段整群随机抽样,对北京市万寿路地区≥60岁老年人群进行横断面调查.MS诊断采用2009年国际统一标准定义;CKD诊断采用2012年国际肾脏病组织的标准定义.结果 共纳入2 102名（其中男性848名,女性1 254名）社区老年人,年龄60 ～ 95（67.9＆#177;5.8）岁.MS患病率为59.1％,CKD患病率为12.6％.随着MS组分数目的增加,CKD的患病率从2.9％增加至18.3％（趋势x2检验P＜0.001）.肾功能下降（2.0％增至8.6％）和白蛋白尿（1.9％增至12.1％）同样呈现增加的趋势（趋势x2检验P＜0.001）.多因素分析结果显示,社区老年人群MS患者患肾功能下降、白蛋白尿、CKD风险是非MS患者的2.13（95％CI：1.39 ～ 2.26）倍、1.99（95％CI：1.41～2.82）倍和2.03（95％CI：1.52 ～ 2.71）倍.且随着MS组分数目的增加,患病风险逐渐增加.不同性别比较,女性人群中MS对肾功能下降（OR：3.30vs.1.27）、CKD（OR：2.19vs.1.89）患病的影响高于男性,而对白蛋白尿的影响低于男性（OR：1.22vs.2.13）.结论 北京城区的社区老年人群MS与CKD患病风险相关,且性别对于老年人群MS与CKD的关系有差异.

Objective To evaluate the association between metabolic syndrome （MS） and chronic kidney disease （CKD） and its sex specific difference among community elder population in China.Methods A population-based cross-sectional study was conducted among the old people aged ≥60 years and selected through a two stage cluster random sampling in a community in Beijing from September 2009 to Jun 2010.The standard international case definitions of MS （2009） and CKD （2012） were used.Results Atotal of 2 102 old people aged 60-95 years,including 848 males and 1 254 females,were surveyed.The prevalence of MS and CKD were 59.1% and 12.6% respectively.The prevalence of CKD increased from 2.9% to 18.3% with the increase of the forms of MS.Multivariate logistic regression analysis showed the ORs of MS for decreased renal function,albuminuria and CKD were 2.13 （95%CI：1.39-2.26）,1.99 （95%CI：1.41-2.82） and 2.03 （95%CI：1.52-2.71） respectively,and the risk of CKD increased with the forms of MS.The impact of MS on decreased renal function was stronger in females （OR：2.19 vs.1.89）,but the impact of MS on albuminuria was stronger in males （OR：1.22 vs.2.13）.Conclusion There was a strong and sex specific association between MS and CKD among the community elder population in Beijing.