中国人群踝臂指数与估算肾小球滤过率的相关性研究

Correlation between ankle brachial index and estimated glomerular filtration in Chinese cohort

目的观察体检患者的踝臂指数(ABI)与估算肾小球滤过率(eGFR),探讨ABI与eGFR之间的相关性。方法纳入2010—2018年于开滦总医院体检的34902名体检者,记录其一般资料和实验室生化指标,计算eGFR,通过测量ABI评估其血管功能。采用多因素logistic回归分析探讨ABI与eGFR相关性。结果在34902名体检者中,患慢性肾脏疾病(CKD)的占30.6%,3.72%体检者的ABI<0.9,0.16%体检者的ABI>0.9。在模型中调整了年龄、性别、收缩压、舒张压、是否患有高血压、糖尿病、吸烟、饮酒、盐摄入量、是否运动、体质指数等,采用logistic回归分析结果显示,与1.1≤ABI<1.4组相比,0.9≤ABI<1.1组的eGFR<90 ml·min^(-1)·1.73 m^(-2)的风险上升(OR=1.108,95%CI:1.049~1.170),ABI<0.9组的eGFR<90 ml·min^(-1)·1.73 m^(-2)的风险上升更明显(OR=1.820,95%CI:1.577~2.102)。结论低ABI与早期肾功能下降相关。当ABI<1.1时,随着ABI指数的降低,体检者eGFR<90 ml·min^(-1)·1.73 m^(-2)的风险显著增加;而当ABI<0.9时,早期肾功能下降风险更高。

Objective To observe the ankle brachial index(ABI)and estimated glomerular filtration rate(eGFR)of the participants,and to explore the correlation between ABI categories and eGFR.Methods The participants in this study included 34,902 subjects who underwent physical examination in the Kailuan cohort study from 2010-2018.General information and laboratory biochemical indicators were recorded,eGFR was calculated to evaluate early stages of chronic kidney disease(CKD),and measuring ABI to predict peripheral atherosclerosis.Multivariate logistic regression analysis was used to explore the correlation between ABI and eGFR.Results Among the 34902 participants,30.6% had CKD.Among all the subjects,3.72% had low ABI(<0.9)and 0.16% had high ABI(>0.9).In models adjusted for age,gender,systolic pressure,diastolic pressure,hypertension,diabetes,drinking,smoking,salt intake,exercising,body mass index,high density lipoprotein,low density lipoprotein,triglyceride,high sensitive C-reactive protein,fast blood glucose,uric acid,urinary protein(qualitative),brachial-ankle pulse wave velocity(baPWV≥1400 cm/s).After adjustment,the results showed that 0.9≤ABI<1.1 was associated with increased odds of having an eGFR<90 ml·min^(-1)·1.73 m^(-2)(OR=1.108,95%CI:1.049-1.170,P=0.0283)compared with group 1.1≤ABI<1.4.And an ABI<0.9 remained significant,and increased odds of having an eGFR<90 ml·min^(-1)·1.73 m^(-2)(OR=1.820,95%CI:1.577-2.102,P=0.0004)compared with group 1.1≤ABI<1.4.Conclusions The study shows that low ABI is associated with low eGFR,and low ABI is associated with early decrements in kidney function.When ABI<1.1,the risk of eGFR<90 ml·min^(-1)·1.73 m^(-2) increases with the decrease of ABI;and the increased risk is more obvious when ABI<0.9.