血红蛋白糖化指数对慢性肾脏病的预测价值

Predictive value of hemoglobin glycation index for chronic kidney disease

目的评估非糖尿病人群中血红蛋白糖化指数(HGI)和慢性肾脏病(CKD)的关系。方法前瞻性队列研究。基线纳入2011年12月至2012年8月于北京市石景山区苹果园社区招募的既往无CKD病史的7407名非糖尿病受试者,依据基线HGI三分位切点分为低、中、高3个组。随访截止时比较不同水平HGI组CKD发生率。使用多因素Cox比例风险模型分析基线HGI水平是否和CKD事件相关,并检验CKD风险随HGI三分位变化的趋势。结果受试者年龄(56.4±7.5)岁,其中女性4933名(66.6%),平均随访时间3.23年。随访期间共有107例(1.4%)新发CKD事件。从低HGI组到高HGI组,CKD发病率逐渐升高[分别为1.1%(28/2473)、1.2%(31/2564)、2.0%(48/2370),P=0.016]。在校正潜在的混杂因素后,以低HGI组为参考,高HGI组CKD发生风险增加了68.5%(HR=1.685,95%CI:1.023~2.774)。CKD风险随HGI三分位水平增加而增加(趋势P值为0.028)。结论高HGI与非糖尿病患者CKD发生风险相关,HGI或可用于识别CKD高危人群。

Objective To investigate the influence of hemoglobin glycation index(HGI)on the risk of incident chronic kidney disease(CDK)among nondiabetic patients.Methods Prospective cohort study.At baseline,a total of 7407 nondiabetic patients without a history of CKD from Pingguoyuan Community of the Shijingshan District in Beijing were included from December 2011 to August 2012,who were then divided into three groups according to the tertiles of their baseline HGI levels.The CKD incidence rate was compared among the different HGI groups at last follow-up.Cox multivariable regression was applied to evaluate whether HGI measures predicted CKD risk.Test for trend across tertiles were examined using ordinal values in separate models.Results The mean age of the subjects was(56.4±7.5)years,and 4933(66.6%)were female.At mean follow-up of 3.23 years,107(1.4%)individuals developed CKD.The incidence of CKD was gradually increasing from the low to high HGI groups[1.1%(28/2473)vs.1.2%(31/2564)vs.2.0%(48/2370),P=0.016].In the multivariate Cox regression analysis,after adjustment for potential confounders,the high HGI group had a 68.5%increased risk of CKD compared with the low HGI group(HR=1.685,95%CI 1.023 to 2.774).CKD risk increased with increasing HGI tertiles(P for trend=0.028).Conclusion High HGI is associated with an increased risk for CKD in the nondiabetic population,indicating that HGI may help identify individuals at high risk for CKD.