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目的·研究中国中老年社区人群肥胖与慢性肾脏疾病(CKD)的相关性。方法·采取整群抽样的方法对上海市嘉定区10 375名40岁及以上的常住居民进行调查。每位受试者均接受标准化问卷调查、体格检查,同时采集空腹血和晨尿标本检测血糖、血脂、肝功能、肾功能、尿白蛋白、尿肌酐等生化指标。肥胖程度的判断采用世界卫生组织(WHO)的诊断标准,将男性和女性按照体质量指数(BMI)分为正常体质量组(BMI<25 kg/m~2)、超重组(25 kg/m2≤BMI<30 kg/m2)、肥胖组(BMI≥30 kg/m2)。依据美国CKD流行病学合作研究组(CKD-EPI)方程计算获得估算的肾小球滤过率。采用Logistic回归分析不同BMI水平人群CKD的患病风险。结果·研究对象各项代谢指标均随着BMI水平的升高而趋向恶化。在校正多种因素后,BMI每增加1 kg/m2,CKD患病风险增加9%,其比值比(OR)为1.09(95%CI:1.07~1.12)。多元Logistic回归分析结果显示,超重组和肥胖组的CKD患病风险较正常体质量组分别增加51%(OR=1.51,95%CI:1.27~1.78)和181%(OR=2.81,95%CI:2.20~3.61)。结论·在中国中老年社区人群中,超重和肥胖者CKD患病风险显著升高。
Objectives · To study the association between obesity and chronic kidney disease (CKD) in Chinese middle-aged and elderly population. Methods · A cluster sampling method was used to investigate 10,375 permanent residents 40 years of age and older in Jiading District of Shanghai. Each subject received a standardized questionnaire, physical examination, fasting blood and morning urine samples were collected to detect blood glucose, blood lipid, liver function, renal function, urinary albumin, urinary creatinine and other biochemical indicators. The degree of obesity was determined according to the diagnostic criteria of the World Health Organization (WHO). Male and female patients were divided into normal weight group (BMI <25 kg / m ~ 2) and overweight group (25 kg / m2 ≤BMI <30 kg / m2), obesity group (BMI≥30 kg / m2). The estimated glomerular filtration rate was calculated according to the CKD-EPI equation of the United States. Logistic regression was used to analyze the prevalence of CKD in different BMI groups. Results · Metabolic indexes of all subjects tended to deteriorate with the increase of BMI. After adjusting for various factors, the risk of CKD increased by 9% for every 1 kg / m2 increase in BMI with a odds ratio (OR) of 1.09 (95% CI: 1.07 to 1.12). Multivariate Logistic regression analysis showed that the risk of CKD in overweight and obesity groups was 51% (OR = 1.51, 95% CI: 1.27-1.78) and 181% (OR = 2.81, 95% CI : 2.20 ~ 3.61). Conclusions · The prevalence of CKD in overweight and obese people is significantly increased among middle-aged and elderly community population in China.