社区人群颈围与肾小球滤过率的相关性

Association of neck circumference with glomerular filtration rate in community population

目的:探讨社区人群中颈围与肾小球滤过率的相关性。方法:选择2016年在徐州市中心医院体检的社区人群11 091人,测量参与者的颈围、腰围、血压等体测指标,留取空腹血并检测血常规、血脂、血清肌酐、空腹血糖、尿微量白蛋白等相关生化指标。估算肾小球滤过率(e GFR)采用中国慢性肾脏疾病患者资料校正的MDRD公式。结果:随着颈围的增大,体检者的血清肌酐、尿微量白蛋白等指标也逐渐升高,其趋势P值均<0.001;校正性别、年龄、BMI、血脂、血压、血糖、尿微量白蛋白等指标后,体检者的e GFR仍随着颈围的增大而降低,其趋势有统计学意义;空腹血糖与颈围、总胆固醇与颈围均对e GFR的数值变化存在交互作用,且在空腹血糖或总胆固醇的不同水平,e GFR均随着颈围的增大而降低。结论:颈围作为e GFR的独立危险因素与慢性肾脏疾病的发生发展有关,且能与空腹血糖或总胆固醇产生交互作用使e GFR进一步降低。

Objective： To investigate the correlation between neck circumference and glomerular filtration rate in community population. Methods： A total of 11 091 people in the community who were physically examined in our hospital in 2016 were selected. Anthropometric indexes including neck circumference, waistline and blood pressure were measured. Biochemical indicators including blood routine, blood lipids, serum creatinine, fasting blood glucose and urine microalbumin were examined. Estimation of glomerular filtration rate （eGFR） was calculated by MDRD formula for chronic renal disease data in China. Results： With the increase of neck circumference, serum creatinine and urinary albumin were gradually increased, the trend P value were 〈0.001. Adjusted by sex, age, BMI, blood lipids, blood pressure, blood glucose and urine microalbumin, the eGFR of the subjects were still decreased with the increase of neck circumference, the trend is statistically significant. We also found the interaction between neck circumference and fasting blood glucose or total cholesterol affects eGFR. With the increase of neck circumference, eGFR is decreased regardless of the levels of total cholesterol and fasting blood glucose. Conclusion： As an independent risk factors of eGFR, neck circumference may associated with the development of chronic renal disease. Moreover, it could interacted with fasting blood glucose or total cholesterol, which further decrease the value of eGFR.