Risk factors for subclinical renal damage and its progression: Hanzhong Adolescent Hypertension Study
Risk factors for subclinical renal damage and its progression: Hanzhong Adolescent Hypertension Study
复制标题
亚临床肾损害及其进展的危险因素：汉中青少年高血压研究
DOI：
10.1038/s41430-020-00752-x
复制
发表时间：
2020-09-29
影响因子：
4.7
通讯作者：
Mu，Jian-Jun
中科院分区：
文献类型：
--
作者：
Wang，Yang;Du，Ming-Fei;Mu，Jian-Jun
慢性肾脏病是一个全球性的公共卫生问题，中国也不例外。本研究的目的是确定亚临床肾病(SRD)在中国人群中发生和发展的危险因素。我们还检验了危险因素对SRD的影响是否随着时间的推移而改变。为了确定SRD的预测因素，我们对汉中青少年高血压队列中的2432名受试者进行了横断面研究。在2005年至2017年的12年间，对202名受试者进行了进一步的分析，以确定SRD的发展和进展的危险因素。结果在横断面分析中，高血压、男性、糖尿病、体重指数和甘油三酯独立地与SRD的高风险相关。在纵向分析中，总胆固醇在4年期间的增加和血清甘油三酯在12年期间的增加独立地与蛋白尿的进展相关。最后，在4年的随访中，总胆固醇和血尿酸的增加与估计的肾小球滤过率(EGFR)的适度下降独立相关。结论在这项对中国队列的研究中，我们发现在中国队列中，几种代谢异常是亚临床肾脏疾病的独立危险因素。此外，我们证明总胆固醇、甘油三酯和尿酸对蛋白尿的发展和进展或EGFR下降的影响在不同的随访点是不同的。这些发现强调了及早发现代谢异常对预防SRD的重要性。
Background/ObjectivesChronic kidney disease (CKD) is a global public health problem, including in China. The aim of this study was to identify the risk factors for the development and progression of subclinical renal disease (SRD) in a Chinese population. We also examined whether the impact of the risk factors on SRD changed over time.Subjects/MethodsTo identify the predictors of SRD, we performed a cross-sectional study of the 2432 subjects in our Hanzhong Adolescent Hypertension Cohort. A subgroup of 202 subjects was further analyzed over a 12-year period from 2005 to 2017 to determine the risk factors for the development and progression of SRD.ResultsIn cross-sectional analysis, elevated blood pressure, male gender, diabetes, body mass index, and triglyceride were independently associated with a higher risk of SRD. In longitudinal analysis, an increase in total cholesterol over a 4-year period and an increase in serum triglyceride over a 12-year period were independently associated with progression of albuminuria. Finally, increases in both total cholesterol and serum uric acid over a 4-year follow-up showed an independent association with a modest reduction in estimated glomerular filtration rate (eGFR).ConclusionsIn this study of a Chinese cohort, we show several metabolic abnormalities as independent risk factors for subclinical renal disease in a Chinese cohort. In addition, we demonstrate that the effects of total cholesterol, triglycerides and uric acid on the development and progression of albuminuria or the decline in eGFR vary at different points of follow-up. These findings highlight the importance of early detection of metabolic abnormalities to prevent SRD.