Kidney-Function Trajectories From Young Adulthood to Midlife: Identifying Risk Strata and Opportunities for Intervention.
Kidney-Function Trajectories From Young Adulthood to Midlife: Identifying Risk Strata and Opportunities for Intervention.
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DOI：
10.1016/j.ekir.2022.10.005
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发表时间：
2023-01
影响因子：
6
通讯作者：
Endre, Zoltan
中科院分区：
文献类型：
--
作者：
Guiney, Hayley;Walker, Robert;Broadbent, Jonathan;Caspi, Avshalom;Goodin, Elizabeth;Kokaua, Jesse;Moffitt, Terrie E.;Robertson, Stephen;Theodore, Reremoana;Poulton, Richie;Endre, Zoltan
了解生命过程中肾脏功能变化的规范模式可能使早期干预成为目标，以减缓或预防肾脏疾病的发生，但对中年前肾脏功能变化的了解有限。本研究使用了一个代表性出生队列的前瞻性纵向数据，以检查从青年到中年的常见变化模式，并确定与较差轨迹相关的风险因素和结果。我们在达尼丁研究出生队列（n = 857）中使用基于组的轨迹模型来确定以下内容：(i) 32岁至45岁之间的常见肾功能轨迹，（ii）与这些轨迹相关的早期生活因素，（iii）与轨迹斜率差异相关的成年期可改变的身体和社会心理因素，以及（iv）轨迹与45岁时肾脏相关结局之间的联系。确定了三个轨迹组，并可按32岁区分如下：正常（58%的参与者），低正常（36%）和高风险（6%）组。那些来自低社会经济背景的人遵循高风险（与正常）轨迹的几率更高。成年期可改变的因素（血压、体重指数、炎症、糖化血红蛋白、吸烟和社会经济地位）与肾功能的年龄相关性下降明显相关，尤其是在低正常和高风险人群中。低正常和高风险组的患者在45岁时也有更多的不良肾脏相关结果。目前的研究结果可以用来为早期干预措施的发展提供信息，并指出整个生命过程中的社会经济条件、与健康相关的风险因素和成年期的行为是肾脏健康促进的目标。
Understanding normative patterns of change in kidney function over the life course may allow targeting of early interventions to slow or prevent the onset of kidney disease, but knowledge about kidney functional change before middle age is limited. This study used prospective longitudinal data from a representative birth cohort to examine common patterns of change from young to midadulthood and to identify risk factors and outcomes associated with poorer trajectories. We used group-based trajectory modeling in the Dunedin study birth cohort (n = 857) to identify the following: (i) common kidney function trajectories between the ages 32 and 45 years, (ii) early-life factors associated with those trajectories, (iii) modifiable physical and psychosocial factors across adulthood associated with differences in trajectory slope, and (iv) links between trajectories and kidney-related outcomes at age 45 years. Three trajectory groups were identified and could be differentiated by age 32 years as follows: normal (58% of participants), low-normal (36%), and high-risk (6%) groups. Those from low socioeconomic backgrounds had higher odds of following a high-risk (vs. normal) trajectory. Modifiable factors (blood pressure, body mass index, inflammation, glycated hemoglobin, smoking, and socioeconomic status) across adulthood were associated with steeper age-related declines in kidney function, particularly among those in the low-normal and high-risk groups. Those in the low-normal and high-risk groups also had more adverse kidney-related outcomes at age 45 years. The current findings could be used to inform the development of early interventions and point to socioeconomic conditions across the life course and health-related risk factors and behaviors in adulthood as kidney health promotion targets.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
13.6
作者：
Delgado, Cynthia;Baweja, Mukta;Powe, Neil R.
通讯作者：
Powe, Neil R.
影响因子：
5
作者：
Belsky, Daniel W.;Caspi, Avshalom;Moffitt, Terrie E.
通讯作者：
Moffitt, Terrie E.
DOI：
10.1053/j.ajkd.2009.07.018
发表时间：
2009-12
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
de Boer IH;Katz R;Fried LF;Ix JH;Luchsinger J;Sarnak MJ;Shlipak MG;Siscovick DS;Kestenbaum B
通讯作者：
Kestenbaum B
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)