Serum Gamma-Glutamyltransferase, Daily Alcohol Consumption, and the Risk of Chronic Kidney Disease: The Kansai Healthcare Study
Serum Gamma-Glutamyltransferase, Daily Alcohol Consumption, and the Risk of Chronic Kidney Disease: The Kansai Healthcare Study
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DOI：
10.2188/jea.je20180240
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发表时间：
2019-03
影响因子：
4.7
通讯作者：
Mikiko Shibata;K. K. Sato-K.;Shinichiro Uehara;Hideo Koh;Keiko Oue;Hiroshi Kambe;Michio Morimoto;Tomoshige Hayashi
中科院分区：
文献类型：
--
作者：
Mikiko Shibata;K. K. Sato-K.;Shinichiro Uehara;Hideo Koh;Keiko Oue;Hiroshi Kambe;Michio Morimoto;Tomoshige Hayashi
背景血清γ-谷氨酰转移酶已被认为是心血管和代谢疾病的危险因素。然而，血清γ-谷氨酰转移酶与慢性肾病风险之间的关系尚不清楚，也没有前瞻性研究单独检查血清γ-谷氨酰转移酶与蛋白尿风险和低估计肾小球滤过率（eGFR）风险之间的关系。方法 我们前瞻性地跟踪了 9,341 名没有低 eGFR、蛋白尿或糖尿病且在入组时未服用抗高血压药物的日本男性进行蛋白尿分析，并跟踪了 9,299 名男性进行低 eGFR 分析。我们将“持续性蛋白尿”定义为每年检查时尿试纸连续两次或多次检测到蛋白尿持续≥1+，直至随访结束。低 eGFR 定义为 eGFR <60 mL/min/1.73 m2。结果 在 11 年的观察期内，151 名男性出现持续性蛋白尿，1,276 名男性出现低 eGFR。在多变量模型中，与最低四分位（≤25 IU/L）相比，血清γ-谷氨酰转移酶的最高四分位（≥71 IU/L）与持续性蛋白尿的发生独立相关（风险比3.39；95%置信区间，1.92-5.97）。在饮酒量和血清γ-谷氨酰转移酶的联合分析中，血清γ-谷氨酰转移酶最高三分位数（≥58 IU/L）的不饮酒者出现持续性蛋白尿的风险最高。然而，血清 γ-谷氨酰转移酶与低 eGFR 之间没有关联。结论 在日本中年男性中，血清 γ-谷氨酰转移酶升高与未来持续性蛋白尿独立相关，但与 eGFR 低无关。
Background Serum gamma-glutamyltransferase has been recognized as the risk factor of cardiovascular and metabolic diseases. However, the association between serum gamma-glutamyltransferase and the risk of chronic kidney disease is not well known, and no prospective studies have examined separately the relationship of serum gamma-glutamyltransferase with the risk of proteinuria versus that of low estimated glomerular filtration rate (eGFR). Methods We prospectively followed 9,341 Japanese men who did not have low eGFR, proteinuria, or diabetes, and did not take antihypertensive medications at entry for the analysis of proteinuria, and we followed 9,299 men for the analysis of low eGFR. We defined “persistent proteinuria” as proteinuria detected two or more times consecutively and persistently as ≥1+ on urine dipstick at the annual check-up until the end of follow-up. Low eGFR was defined as eGFR <60 mL/min/1.73 m2. Results During the 11-year observation period, 151 men developed persistent proteinuria and 1,276 men developed low eGFR. In multivariate models, the highest quartile (≥71 IU/L) of serum gamma-glutamyltransferase was independently related to the development of persistent proteinuria (hazard ratio 3.39; 95% confidence interval, 1.92–5.97) compared with the lowest quartile (≤25 IU/L). In joint analysis of alcohol consumption and serum gamma-glutamyltransferase, non-drinkers in the highest tertile (≥58 IU/L) of serum gamma-glutamyltransferase had the highest risk of persistent proteinuria. However, there was no association between serum gamma-glutamyltransferase and low eGFR. Conclusion In middle-aged Japanese men, elevated serum gamma-glutamyltransferase was independently associated with future persistent proteinuria, but not with low eGFR.