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目的研究长寿地区血肌酐正常的中老年人血尿酸(UA)水平和早期肾功能损害的关系及其早期肾功能损害的患病率。方法利用中国老人健康长寿影响因素研究数据,选取血肌酐正常的1542人,进行慢性肾脏疾病及相关危险因素的问卷调查、体格检查和血尿检测,评价肾功能采用MDRD方程估计的肾小球滤过率(eGFR),分析该人群早期肾功能损害的患病率,并将人群按血UA水平四分位间距分成4组,分析血UA水平和早期肾功能损害的关系。结果该人群早期肾功能损害的患病率为55.25%(95%CI为52.77%～57.74%),在男女性中,血UA水平均和eGFR呈负相关。Logistics回归模型校正了性别、年龄、腰围、高TG、高TC、高HDL-C、高LDL-C、高血压病和糖尿病因素后,以A组作为对照,人群早期肾功损害的OR值B组为1.673(95%CI为1.254～2.235,P=0.191 9),C组为2.491(95%CI为1.854～3.357,P=0.002 2)及D组为3.009(95%CI为2.200～4.134,P﹤0.000 1)。结论长寿地区血肌酐正常的中老年人中,早期功能损害的患病率很高,血UA水平和早期肾功能损害独立相关。
Objective To investigate the relationship between serum uric acid (UA) level and early renal dysfunction in elderly patients with normal serum creatinine in longevity and the prevalence of early renal dysfunction. Methods According to the data of influencing factors on health and longevity of the elderly in China, 1542 people with normal serum creatinine were selected for questionnaire survey, physical examination and hematuria of chronic kidney disease and related risk factors to evaluate the renal function. The GFR estimated by MDRD Rate (eGFR). The prevalence of early renal dysfunction in this population was analyzed. The population was divided into four groups according to the interquartile range of UA. The relationship between blood UA level and early renal dysfunction was analyzed. Results The prevalence of early renal impairment in this population was 55.25% (95% CI: 52.77% -57.74%). In both men and women, the blood UA level was negatively correlated with eGFR. Logistic regression model adjusted the OR of BMI in group A as a control after adjusting for gender, age, waist circumference, high TG, high TC, high HDL-C, high LDL-C, hypertension and diabetes. Group C was 2.491 (95% CI 1.854-3.357, P = 0.002 2) and Group D was 3.009 (95% CI 1.252-2.335, P = 0.191 9) P <0.000 1). Conclusion The prevalence of early functional impairment is very high in middle-aged and elderly people with normal serum creatinine in longevity. The blood UA level is independently related to the early renal dysfunction.