Increased pulse wave velocity is associated with low creatinine clearance and proteinuria in a screened cohort
Increased pulse wave velocity is associated with low creatinine clearance and proteinuria in a screened cohort
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DOI：
10.1053/j.ajkd.2006.01.027
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发表时间：
2006-05-01
影响因子：
13.2
通讯作者：
Takishita, Shuichi
中科院分区：
文献类型：
--
作者：
Ohya, Yusuke;Iseki, Kunitoshi;Takishita, Shuichi
背景：慢性肾脏病（CKD）是未来心血管疾病的危险因素。虽然反映动脉硬度的脉搏波速度（PWV）在CKD受试者中增加，但关于肾功能是否与低风险人群中的PWV相关以及蛋白尿和肾功能下降是否协同影响PWV，我们知之甚少。方法：研究对象为参加日本冲绳健康检查项目的3,387人（平均年龄52岁）。我们用自动血压计法测量了臂踝PWV（baPWV）。蛋白尿用试纸法半定量。采用Cockcroft-Gault公式计算肌酐清除率（CCr）。结果如下：baPWV随着年龄、收缩压、空腹血糖水平和总胆固醇水平的增加、男性、蛋白尿的存在和CCr的降低而加速。在多元回归分析中，所有这些因素都能独立预测baPWV。当受试者根据Ccr ≥ 90、60 - 89或30 - 59 ml分为6组时，min（>= 1.50，1.00 - 1.48，或0.50 - 0.98 mL/s）和有无蛋白尿（baPWV），在校正年龄、性别和收缩压后，呈阶梯式增加，对应于CCr的降低，而与蛋白尿无关，在存在蛋白尿时，这种关系被夸大。结论：动脉僵硬度随肾功能下降或蛋白尿而增加，与其他危险因素无关。
Background: Chronic kidney disease (CKD) is a risk factor for future cardiovascular disease. Although pulse wave velocity (PWV), which reflects arterial stiffness, was increased in subjects with CKD, little is known regarding whether renal function is associated with PWV in a low-risk population and whether proteinuria and decreased renal function synergistically affect PWV. Methods: Subjects are 3,387 persons (mean age, 52 years) who attended a health checkup program in Okinawa, Japan. We measured brachial-ankle PWV (baPWV) by using an automatic oscillometric method. Proteinuria was semiquantified by using the dipstick method. Creatinine clearance (CCr) was estimated by using the Cockcroft-Gault formula. Results: baPWV was accelerated with increases in age, systolic blood pressure, fasting glucose level, and total cholesterol level; male sex; presence of proteinuria; and decrease in CCr. All these factors independently predicted baPWV in multiple regression analysis. When subjects were divided into 6 groups according to CCr of 90 or greater, 60 to 89, or 30 to 59 ml./min ( >= 1.50, 1.00 to 1.48, or 0.50 to 0.98 mL/s) and the absence or presence of proteinuria, baPWV, after adjustment for age, sex, and systolic blood pressure, increased in a stepwise fashion corresponding to decreases in CCr regardless of proteinuria, with the relationship exaggerated in the presence of proteinuria. Conclusion: Arterial stiffness increases with a decrease in renal function or with proteinuria independently of other risk factors.