健康体检成人慢性肾脏病患病现况及其危险因素研究

A cross-sectional study on the prevalence and risk factors of chronic kidney disease in health examination adults

目的探讨健康体检成人慢性肾脏病(CKD)的患病现况及其危险因素。方法选取2019年1月至12月接受年度健康体检的42223例受检者为研究对象,分为CKD患者和健康对照人群,采用横断面研究方法进行研究。采用问卷方式收集受检者的基本情况,包括年龄、性别、婚姻状况、受教育程度、吸烟史、饮酒史、体育锻炼、既往疾病史等;通过健康体检测量受检者身高、体重、腰围、血压,并收集实验室检查指标,包括空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血尿酸、肌酐及尿常规等。采用logistic回归分析CKD的影响因素。结果共纳入研究对象42223例,CKD患病率为5.62%,其中男性患病率为7.77%,女性患病率为3.39%;CKD的患病率随年龄的增长而增加,≥80岁CKD患病率最高,为25.84%,其次为70~79岁(13.08%),且各年龄组男性CKD患病率均高于女性。检出的CKD患者以早期阶段(1-2期)最多,早期CKD总患病率为5.13%。多因素logistic回归分析结果显示,年龄70~79岁(OR:1.63,95%CI:1.17~2.27)、≥80岁(OR:0.82,95%CI:2.61~5.91)、男性(OR:1.55,95%CI:2.61~5.91)、舒张压升高(OR:1.014,95%CI:1.007~1.021)、空腹血糖水平升高(OR:1.22,95%CI:1.17~1.27)、高血压(OR:1.44,95%CI:1.23~1.68)、冠心病(OR:1.36,95%CI:1.10~1.69)、脑卒中(OR:1.63,95%CI:1.09~2.43)是CKD患病的独立危险因素(均P<0.05);体育锻炼>60 min/d(OR:0.82,95%CI:0.70~0.96)是CKD患病的保护因素(均P<0.05)。结论健康体检人群中CKD患病率较低,多处于患病早期阶段,且高龄,男性,舒张压升高,空腹血糖升高,患高血压、冠心病、脑卒中与CKD患病有关。

Objective To investigate the prevalence and related factors of chronic kidney disease(CKD).Methods A total of 42223 subjects who received annual physical examination from January to December 2019 were selected as the research objects,a cross-sectional study was conducted.They were divided into CKD patients and healthy control groups.The basic information of the subjects was collected by questionnaire,including age,sex,marital status,education level,smoking history,drinking history,physical exercise and previous disease history,etc.The height,weight,waist circumference and blood pressure of the subjects were measured through physical examination,and laboratory indicators including fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,blood uric acid,creatinine and urine routine were collected.The influencing factors of CKD were analyzed by logistic regression.Results A total of 42223 subjects were included in the study.The prevalence of CKD was 5.62%,with 7.77%in males and 3.39%in females.The prevalence of CKD increased with age.The prevalence of CKD was the highest in≥80 years old(25.84%),followed by 70-79 years old(13.08%),the prevalence of CKD in males was higher than that in females in all age groups.Most of the detected CKD patients were in the early stage(stage 1-2),and the total prevalence of early CKD was 5.13%,and the total prevalence of stage 3-5 was 0.49%.Multivariate logistic regression analysis showed that age 70-79 years old(OR:1.63,95%CI:1.17-2.27),≥80 years old(OR:0.82,95%CI:2.61-5.91),male(OR:1.55,95%CI:2.61-5.91),high diastolic blood pressure(OR:1.014,95%CI:1.007-1.021),high fasting blood glucose level(OR:1.22,95%CI:1.17-1.27),SUA(OR:1.001,95%CI:1.000-1.002),hypertension(OR:1.44,95%CI:1.23-1.68),coronary heart disease(OR:1.36,95%CI:1.10-1.69)and stroke(OR:1.63,95%CI:1.09-2.43)were independent risk factors for CKD(all P<0.05);Physical activity 15-30 min/day(OR:0.81,95%CI:0.71-0.93),>60 min/day(OR:0.82,95%CI:0.70-0.96)was a protective factor for the prevalence of CKD(all P<0.05)Conclusion The prevalence of CKD in the health check-up population is low,and most of them are in the early stage of the disease.The prevalence of CKD is related to male,old age,physical exercise,elevated diastolic blood pressure,elevated blood glucose,elevated blood uric acid,hypertension,coronary heart disease,and stroke.