连云港农村45～75岁高血压人群血脂水平和肾小球高滤过关系的研究

Study on relationship between lipid profiles and glomerular hyper-filtration in rural hypertensive patients aged 45-75 years in Lianyungang

目的 探索连云港农村45-75岁高血压人群甘油三酯（triglyceride,TG）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）及甘油三酯-高密度脂蛋白胆固醇比值（triglyceride to high-density lipo-protein cholesterol,TG/HDL-C）和肾小球高滤过的关联性。方法 对2008-2009年参加中国连云港农村开展的中国脑卒中一级预防研究调查的17145例45-75岁原发性高血压患者进行调查,内容包括问卷调查、体格及实验室指标检测;采用CKD-EPI公式计算肾小球滤过率（estimated glomerula rfiltration rate,eGFR）水平;将大于eGFR残差值（调整了年龄和性别后）90%分位数定义为肾小球高滤过。结果 多因素Logistic回归结果显示,每增加一个单位Log-TG可使肾小球高滤过的发生风险增加4.45倍（95%CI：3.96-5.02）;同样,每增加一个单位Log-TG/HDL-C比值可使肾小球高滤过的发生风险增加3.10倍（95%CI：2.85-3.38）。HDL-C和肾小球高滤过在女性人群中呈负相关。结论 TG及TG/HDL-C比值和肾小球高滤过呈独立正相关关系,而HDL-C和肾小球高滤过仅在女性人群中呈负相关。

Objective To investigate the relationship of triglyceride（ TG）,high-density lipoprotein cholesterol（ HDL-C）,or triglyceride to high-density lipoprotein cholesterol（ TG/HDL-C） ratio and glomerular hyper-filtration in a rural hypertensive population aged 45-75 years in Lianyungang. Methods 17 145 individuals with hypertension,aged 45-75 years from the China Stroke Primary Prevention Trial（ CSPPT） conducted in Lianyungang rural areas between 2008 and2009 were included in the final analysis. All participants had a questionnaire,physical exam and laboratory testing completed in the study. Estimated glomerular filtration rate（ e GFR） was calculated based on the equation of CKD-EPI. Renal hyper-filtration was defined as an absolute e GFR 90 th percentile after adjusting for sex and age. Results Multivariate adjusted Logistic regression models showed that,the log-TG was significantly associated with glomerular hyper-filtration,with odds ratio（ OR） of 4. 45（ 95% CI： 3. 96-5. 02）; similarly,the log-TG / HDL-C ratio was associated with an OR of 3. 10（ 95% CI： 2. 85-3. 38） for glomerular hyper-filtration; HDL-C was negatively associated with glomerular hyper-filtration after multivariate adjustment in females. Conclusions TG and TG / HDL-C ratio were positively associated with glomerular hyper-filtration,while HDL-C was negatively associated with glomerular hyper-filtration in females.