| 摘要: |
| 目的研究普通成人血尿酸水平在肾功能损害进展中的作用，探讨时间-平均血尿酸水平升高与慢性肾脏病（CKD）的关系。方法回顾性分析2011年1月1日至2016年12月31日每年参与全面体检且初始肾功能正常的5701例普通成人的临床资料。采集所有体检者的基线特征指标，并于随访期间每年测定1次血尿酸水平及估计肾小管滤过率（eGFR），按基线血尿酸和时间-平均血尿酸水平分为4分组，通过二元logistic回归分析和Cox比例风险模型等统计学方法评估不同分组与CKD之间的关系。结果在6年随访时间里，共有249例体检者进展为CKD。多因素校正的logistic回归分析发现，新发CKD的风险随着时间-平均血尿酸水平升高而增大，与对照的第1组相比，第2~4组的相对危险度(OR)分别为2.709（95%CI:1.836~5.293）、3.754（95%CI:1.898~7.428）、7.462（95%CI:3.694~15.073）。同时，调整潜在混杂因素后的Cox比例风险模型显示，基线血尿酸和时间-平均血尿酸水平的升高均会增大CKD的发生风险，第4个基线血尿酸四分位数的风险比（HRs）为1.689（95%CI:1.058~2.696），第4个时间-平均血尿酸四分位数的HRs为6.320（95%CI:3.285~12.159）。结论普通成人基线血尿酸及时间-平均血尿酸水平的升高均与肾功能损害及新发CKD具有独立相关性。 |
| 关键词: 血尿酸 时间 - 平均血尿酸 慢性肾脏病 高尿酸血症 |
| DOI：10.12056/j.issn.1006-2785.2018.40.9.2017-2390 |
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| Association between time-mean serum uric acid levels and chronic kidney disease |
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the Second Clinical Medical College，Zhejiang Chinese Medical University
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| Abstract: |
| Objective To investigate the association between time-mean serum uric acid (SUA) levels and chronic kidney disease (CKD). Methods Clinical data of 5 701 subjects undergoing annually health check-up between January 2011 and December 2016 were retrospectively analyzed. All participants had an estimated glomerular filtration rate(eGFR) ＞ 60ml/min/1.73m2 at baseline. The uric acid and eGFR were assessed every year in the follow-up period. The subjects were classified into 4 groups according the sex-specific quartiles of time-mean SUA values. The risk of new development of CKD among different stratified groups was evaluated. Results During 6 years of follow-up, 249(4.4%) participants developed CKD. Multivariate analysis showed that compared to the reference, the odds ratio (OR) for the new cases of CKD increased with higher time-mean SUA levels (OR=2.709, 95% CI:1.836-5.293, OR=3.754, 95% CI:1.898-7.428 and OR=7.462,95% CI:
3.694-15.073, for the second, third and fourth quartiles respectively; all P＜0.05). Multivariate Cox proportional hazard model after adjustment for potential confounders showed that the adjusted HRs of highest quartile vs. lowest quartile for baseline and time-mean uric acid were 1.689 (95% CI:1.058-2.696) and 6.320 (95% CI:3.285-12.159), respectively. Conclusion The Increasing of baseline SUA and time-mean SUA value is independently associated with increased likelihood for eGFR decline and incidence CKD in the general population. |
| Key words: Serum uric acid Time-mean serum uric acid Chronic kidney disease Hyperuricemia |
