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背景脉搏波传导速度(PWV)能一定程度上反映各种危险因素对血管的损伤,是心血管疾病危险率的独立预测因子。尿微量白蛋白和肌酐比值(MACR)与估算的肾小球滤过率(eGFR)可用于评估心血管病危险性。目的了解在成年人群中不同水平PWV的MACR、eGFR之间是否有差异以及它们之间是否存在关联。方法研究对象为整群抽样自愿参加河北省清河县高钾低钠盐试验的家庭成员,选取年龄40～75岁且资料完整的414人(男性160人,女性254人)作分析。抽取12h空腹静脉血。收集点尿,测定尿微量白蛋白、肌酐,计算MACR和eGFR。测定颈股动脉脉搏波传导速度(cfPWV)作为评估大动脉弹性功能的指标。结果根据cfPWV四分位把人群分组后,发现收缩压、舒张压和MACR均随着cfPWV水平升高而升高,eGFR随着cfPWV水平升高而降低;使用偏相关分析,控制年龄,发现cfPWV与收缩压、舒张压、平均动脉压(MAP)呈显著正相关(r分别为0.539、0.429、0.513,均P<0.01),cfPWV与eGFR呈负相关(r=-0.113,P<0.05);Spearman相关分析显示cfPWV与MACR正相关(rs值为0.157,P<0.01);线性回归模型表明在男性中排除了年龄、MAP、体质量指数的影响后,cfPWV仍与eGFR呈负相关(t=-2.046,P=0.042),与MACR呈正相关(t=2.232,P=0.027)。结论该成年人群血压、MACR与cfPWV之间存在正相关;cfPWV与eGFR呈负相关;在男性中cfPWV对MACR和eGFR可能有一定的预测作用。
Background Pulse wave velocity (PWV) can reflect the damage of blood vessels to a certain extent by various risk factors and is an independent predictor of cardiovascular disease risk. Urinary microalbumin and creatinine ratio (MACR) and estimated glomerular filtration rate (eGFR) can be used to assess the risk of cardiovascular disease. Objectives To understand whether there is a difference between MACR and eGFR at different levels of PWV among adults and whether there is a correlation between them. METHODS: The subjects of the study were cluster members sampled from families who volunteered to participate in the high-potassium and low-sodium salt test in Qinghe County, Hebei Province. The data were collected from 414 aged 40-75 years old with data complete (160 males and 254 females). 12h fasting venous blood drawn. Urine was collected, urinary microalbuminuria and creatinine were measured, and MACR and eGFR were calculated. The carotid artery pulse wave velocity (cfPWV) was measured as an index for assessing the elasticity of the aorta. Results According to the quartiles of cfPWV, the systolic blood pressure, diastolic blood pressure and MACR increased with the increase of cfPWV level and eGFR decreased with the increase of cfPWV level. Using partial correlation analysis and age control, it was found that cfPWV (R = -0.113, P <0.05). There was a significant positive correlation between systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP) Spearman correlation analysis showed that there was a positive correlation between cfPWV and MACR (rs = 0.157, P <0.01). The linear regression model showed that cfPWV was still negatively correlated with eGFR in men excluding age, MAP and body mass index (t = -2.046, P = 0.042), which was positively correlated with MACR (t = 2.232, P = 0.027). CONCLUSION: There is a positive correlation between blood pressure and MACR and cfPWV in this adult population; cfPWV and eGFR are negatively correlated; cfPWV may have some predictive value for MACR and eGFR in males.