高血浆黏度与肾功能进展的关系

Relationship between high plasma viscosity and renal function progression

目的探讨高血浆黏度(PV)与肾功能进展的关系,为控制慢性病、提高人群生命质量提供依据。方法采用回顾性研究收集2005年1月—2012年12月徐州市中心医院重复健康体检者资料。将暴露于高PV者(暴露组214例)与未暴露于高PV者(非暴露组642例)按1∶3配对,比较血肌酐(Scr)、血尿酸(UA)及肾小球滤过率(GFR)等指标。结果两组入组时各指标均衡可比,经过7年随访观察,两组年龄、身高、体重、收缩压、舒张压、血尿素氮(BUN)、高密度脂蛋白(HDL)、UA及血糖(GLU)比较,差异无统计学意义(P>0.05);暴露组Scr、总胆固醇(TC)、甘油三酯、PV较非暴露组高(P<0.05),而GFR较非暴露组低(P <0.05);暴露组肾功能进展患病率高于非暴露组(P <0.05);TC中介效应为17.7%。结论高PV很可能通过TC的介导,成为慢性肾脏病的危险因素。

Objective To investigate the relationship between high plasma viscosity and renal function progression and to provide evidence to control chronic diseases and improve the life quality of population. Methods The data of repeated healthy examinees in Xuzhou Central Hospital from January 2005 to December 2012 were collected. By using a retrospective study, the participants exposed to high plasma viscosity and those not exposed to high plasma viscosity were matched at 1: 3. And indexes, such as serum creatinine, uric acid and glomerular filtration rate, were compared. Results The indexes of the two groups were balanced and comparable when they entered the group. After 7 years, there were no statistical differences between the two groups regarding age, height, weight, SBP, DBP, urea nitrogen, high density lipoprotein, uric acid and glucose (P > 0.05). Compared with the non-exposed group, serum creatinine [(66.99±32.29) vs (55.46±15.97 mg/dL)], total cholesterol [(5.01±0.74) vs (4.87±0.72 mmol/L)], triglyceride [(1.80±1.79 mmol/L) vs (1.45±0.58 mmol/L)] and plasma viscosity [(1.60±0.07 mPa·s)vs (1.54±0.06 mPa·s)] in the exposure group were higher, but glomerular filtration rate [(131.05±49.06 ml/min·1.73 m2) vs (144.53±34.10 ml/min·1.73 m2)] were lower, significantly (P < 0.05). The prevalence rate of renal function progression in the exposure group (5.83%) was higher than that in the non-exposed group (3.62%)(P < 0.05). The mediating effect of total cholesterol was 17.7%(P < 0.05). Conclusions High plasma viscosity is likely to be a risk factor for CKD mediated by total cholesterol.