上海延吉社区65岁以上老年人慢性肾脏病患病及影响因素分析

Analysis of the prevalence of the chronic kidney disease in the elderly over 65 years old and the related influencing factors in Yanji Community of Shanghai

目的:研究上海市延吉社区65岁以上老年人慢性肾脏病(CKD)的患病率及其相关的影响因素,为早期预防及干预提供依据。方法:对2019年上海市延吉社区1893名65岁以上老年人(男性852人,女性1041人,)进行空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、血尿酸(UA)、血肌酐(SCr)、血同型半胱氨酸(Hcy)、总胆红素、丙氨酰氨基转移酶(AST)、门冬氨酸氨基转移酶(AST)检测,计算eGFR。留取尿液检测尿常规、尿白蛋白、尿肌酐,计算尿白蛋白/肌酐比值(ACR),同时测量身高、体重、腰围,计算BMI。分析社区老年人的CKD患病情况及其影响因素。结果:上海延吉社区65岁以上老年人CKD患病率31.91%;男性患病率32.63%,女性患病率31.32%;高龄(≥80岁)老年人患病率42.72%;蛋白尿、血尿及eGFR下降的未标化患病率分别为20.07%、7.44%和4.90%。多因素分析显示年龄(OR=1.669,95%CI:1.234~2.258,P=0.001)、Hcy(OR=1.365,95%CI:1.115~1.670,P=0.003)、UA(OR=1.768,95%CI:1.353~2.309,P<0.001)、HbA1c(OR=1.779,95%CI:1.306~2.422,P<0.001)、肥胖(OR=1.575,95%CI:1.090~2.275,P=0.015)、HDL-c(OR=0.869,95%CI:0.763~0.989,P=0.034)与CKD有关。结论:年龄、Hcy、UA、HbA1c、肥胖、HDL-c是CKD发生的影响因素。

Objective:To study the prevalence of the chronic kidney disease(CKD)in the elderly over 65 years old in Yanji Community of Shanghai and the related influencing factors,so as to provide the basis for early prevention and intervention.Methods:In 2019,1893 elderly people over 65 years old(852 males and 1041 females)in Yanji Community of Shanghai were examined for fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,blood uric acid,blood creatinine,blood homocysteine,total bilirubin,alanyl aminotransferase,and glutamic oxaloacetylase,and EGFR was calculated.Urine was retained to test urine routine,urine albumin,urine creatinine and calculation of urine albumin/creatinine ratio(ACR),and at the same tine height,weight and waist circumference were measured to calculate BMI.The prevalence of CKD in the community and the influencing factors were analyzed.Results:The prevalence of CKD in elderly people over 65 years old in the Yanji Community of Shanghai was 31.91%;the prevalence of men was 32.63%,and the prevalence of women was 31.32%;the prevalence of senior citizens(≥80 years old)was 42.72%;the unstandardized prevalence rates of decreased proteinuria,hematuria and EGFR were 20.07%,7.44%and 4.90%,respectively.Multivariate analysis showed age(OR=1.669,95%CI:1.234~2.258,P=0.001),homocysteine(OR=1.365,95%CI:1.115~1.670,P=0.003),blood uric acid(OR=1.768,95%CI:1.353~2.309,P<0.001),glycosylated hemoglobin(OR=1.779,95%CI:1.306~2.422,P<0.001),obesity(OR=1.575,95%CI:1.090~2.275,P=0.015),high-density lipoprotein cholesterol(OR=0.869,95%CI:0.763~0.989,P=0.034)were related to CKD.Conclusion:Age,homocysteine,blood uric acid,glycosylated hemoglobin,obesity and high-density lipoprotein cholesterol are the influencing factors of CKD.