广西35~74岁壮族居民慢性肾脏病患病及其与代谢综合征的相关性研究

The relationship of chronic kidney disease with metabolic syndrome in Zhuang minority aged of 35-74 years in Guangxi

目的:了解广西35~74岁壮族居民慢性肾脏病(CKD)患病现状及影响因素,探讨CKD与代谢综合征(MS)的关系,为CKD筛查和防制措施的制定提供依据。方法:基于广西少数民族自然人群队列对35~74岁壮族居民进行问卷、身体指标资料收集;采用Logistic回归分析CKD的影响因素,采用趋势性卡方检验分析CDK患病率与MS代谢紊乱因素个数的关系。结果:共纳入研究对象10703例,平均年龄(55.6±10.4)岁,CKD患病率为11.8%,男性患病率(13.7%)高于女性(10.3%);肾功能下降和蛋白尿阳性率分别为2.9%和8.9%。MS患者中CKD患病率为15.8%,CKD患病率、肾功能下降和蛋白尿阳性率随MS代谢紊乱因素个数增多而升高(P<0.001)。多因素Logistic回归显示,男性(OR=2.031)、高年龄(OR=11.672)、高血压(OR=1.484)、高血糖(OR=1.476)、低HDL-C血症(OR=2.059)、高尿酸血症(OR=4.252)、高胆固醇血症(OR=2.216)是肾功能下降的危险因素(均P<0.05);吸烟(OR=1.392)、高血压(OR=1.212)、高血糖(OR=2.602)、低HDL-C血症(OR=1.171)、中心性肥胖(OR=1.199)、尿素升高(OR=2.639)是蛋白尿阳性的危险因素(均P<0.05)。结论:广西35~74岁壮族居民CKD患病率较高,肾功能下降、蛋白尿阳性率与MS代谢紊乱因素个数密切相关,加强MS防控可有效降低CKD的发生。

Objective:To determine the prevalence and risk factors of chronic kidney disease(CKD)in Guangxi Zhuang minority residents aged of 35-74 years,and to explore the relationship between CKD and metabolic syndrome(MS),providing evidences for the strategies of CKD screening,prevention and control.Methods:Based on the Guangxi Ethnic Minority Natural Population Cohort Project,a questionnaire survey and physical examinations were conducted.Logistic regression was used to analyze the risk factors of CKD and proportion trend test was used to explore the correlation between CKD and the components of MS.Results:A total of 10,703 Zhuang minority residents aged of 35-74 years were enrolled with the mean age of(55.6±10.4)years.The prevalence of CKD was 11.8%.The prevalence in males(13.7%)was higher than females(10.3%).Thepercentage of subjects with renal function declined and proteinuria were 2.9%and 8.9%respectively.A total of 15.8%of the MS patients had CKD disease.The prevalence of CKD,renal function declined and proteinuria were increased as the number of MS components increased.Gender(OR=2.031),age(OR=11.672),hypertention(OR=1.484),hyperglycemia(OR=1.476),low HDL-C(OR=2.059),hyperuricemia(OR=4.252),and hypercholesterolemia(OR=2.216)were risk factors of renal function decline.Smoking(OR=1.392),hypertension(OR=1.212),hyperglycemia(OR=2.602),low HDL-C(OR=1.171),central obesity(OR=1.199)and increased urea nitrogen(OR=2.639)were risk factors of proteinuria(P<0.05).Conclusion:The prevalence of CKD in Guangxi Zhuang nationality aged of 35-74 years was relatively high.Renal function decline and proteinuria were closely related to the number of MS components.Strengthening the prevention and control of MS can effectively reduce the incidence of CKD.