Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: The CHOICE study
Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: The CHOICE study
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DOI：
10.1097/01.asn.0000019641.41496.1e
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发表时间：
2002-07-01
影响因子：
13.6
通讯作者：
Klag, MJ
中科院分区：
文献类型：
--
作者：
Longenecker, JC;Coresh, J;Klag, MJ
尽管终末期肾病 (ESRD) 中动脉粥样硬化性心血管疾病 (ASCVD) 的风险是普通人群的 5 至 30 倍，但将新透析患者与普通人群中 ASCVD 危险因素进行比较的数据却很少。这项针对 1041 名透析患者的横断面研究描述了 ESRD 开始时 ASCVD 危险因素的患病率，并与第三次全国健康和营养检查 (NHANES III) 得出的美国成年人群 ASCVD 危险因素的估计值进行了比较。 CHOICE 研究参与者的糖尿病（54%）、高血压（96%）、心电图（EKG）标准左心室肥厚（22%）、体力活动低（80%）、高甘油三酯血症（36%）和低 HDL 胆固醇（33%）的患病率较高。与 NHANES III 参与者相比，CHOICE 参与者更有可能是老年人、黑人和男性。调整年龄、种族、性别和 ASCVD（在 CHOICE 中定义为心肌梗塞、血运重建手术、中风、颈动脉内膜切除术和截肢；在 NHANES III 中定义为心肌梗塞和中风）后，糖尿病、高血压、心电图显示的左心室肥大、低体力活动、低 HDL 胆固醇和高甘油三酯血症的患病率在 CHOICE 参与者中仍然更常见。然而，与 NHANES III 参与者相比，吸烟、肥胖、高胆固醇血症和高 LDL 胆固醇在 CHOICE 中并不常见。根据 Framingham 风险方程，在 40 岁以上无 ASCVD 的人群中，预计 5 年 ASCVD 风险在 CHOICE 研究参与者中 (13%) 高于 NHANES III 参与者 (6%)。总之，许多 ASCVD 危险因素在 ESRD 中比在一般人群中更为普遍，并且可以解释 ESRD 中 ASCVD 风险增加的部分原因，但可能不是全部。
Although atherosclerotic cardiovascular disease (ASCVD) risk in end-stage renal disease (ESRD) is 5 to 30 times that of the general population, few data exist comparing ASCVD risk factors among new dialysis patients to the general population. This cross-sectional study of 1041 dialysis patients describes the prevalence of ASCVD risk factors at the beginning of ESRD compared with estimates of ASCVD risk factors in the adult US population derived from the Third National Health and Nutrition Examination (NHANES III). CHOICE Study participants had a high prevalence of diabetes (54%), hypertension (96%), left ventricular hypertrophy by electrocardiogram (EKG) criteria (22%), low physical activity (80%), hypertriglyceridemia (36%), and low HDL cholesterol (33%). CHOICE participants were more likely to be older, black, and male than NHANES III participants. After adjustment for age, race, gender, and ASCVD (defined as myocardial infarction, revascularization procedure, stroke, carotid endarterectomy, and amputation in CHOICE; and as myocardial infarction and stroke in NHANES III), the prevalence of diabetes, hypertension, left ventricular hypertrophy by EKG, low physical activity, low HDL cholesterol, and hypertriglyceridemia were still more common in CHOICE participants. Smoking, obesity, hypercholesterolemia, and high LDL cholesterol, however, were less common in CHOICE than NHANES III participants. The projected 5-yr ASCVD risk based on the Framingham Risk Equation among those older than 40 yr without ASCVD was higher in CHOICE Study participants (13%) than in the NHANES III participants (6%). In Summary, many ASCVD risk factors are more prevalent in ESRD than in the General population and may explain some, but probably not all, of the increased ASCVD risk in ESRD.