维持性血液透析患者代谢综合征患病现状及危险因素的多中心调查

Multicenter survey on the prevalence and risk factors of metabolic syndrome among patients with maintenance hemodialysis

目的:了解维持性血液透析(MHD)患者代谢综合征(MS)的患病现状,并分析其相关的危险因素。方法:收集郑州市7个血液净化中心472例MHD患者的临床资料,分为MS组与非MS组,比较两组患者的一般资料、体格检查、透析资料、实验室检查等。对与MS发生可能相关的危险因素进行多因素Logistic回归分析。结果:MS的患病率为34.75%。两组间体重、腰围、腰臀比、透析频率、每周透析时间、尿素氮下降率、尿素清除指数(Kt/v)、血清铁、全段甲状旁腺激素(i PTH)、白细胞、超敏C-反应蛋白(hs-CRP)相比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果提示血清铁(OR=1.084,P=0.042)、i PTH(OR=1.754,P=0.035)、腰臀比(OR=2.013,P=0.021)、hs-CRP(OR=4.245,P=0.000)与MS的发生相关。结论:MHD患者MS的患病率较高,血清铁、i PTH、腰臀比、hs-CRP可能是MHD患者发生MS的危险因素。

Objective To investigate the prevalence of metabolic syndrome in patients with maintenance hemodialysis, and to analyze the potential risk factors. Methods The clinical data of 472 patients with maintenance hemodialysis from 7 blood purification centers were collected. Patients were divided into the MS group and the non-MS group. The demographic data, anthropometric examinations, dialysis prescription and results of laboratory were compared between these two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of MS. Results The morbidity of MS was 34.75%. There were significant differences in weight, waist circumference, waist-hip ratio, frequency of dialysis, time of hemodialysis perweek,urea reduction ratio, urea clearance index（Kt / v）, iron, intact parathyroid hormone（i PTH）, leukocytes, high sensitivity C-reactive protein（hs-CRP） between these two groups（P〈0.05, resectively）. Multivariate Logistic regression analysis revealed that iron（OR = 1.084, P = 0.042）, i PTH（OR = 1.754, P = 0.035）, waist-hip1ratio（OR = 2.013,P = 0.021）, hs-CRP（OR = 4.245,P = 0.000）were correlated with MS. Conclusion The morbidity of MS in patients with maintenance hemodialysis is higher. Iron, i PTH, waist-hip ratio, hs-CRP are potential risk fctors of MS for the patients with maintenance hemodialysis.