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目的横断面调查正常或轻度受损社区居民估测的肾小球滤过率(eGFR)及传统心血管危险因素与脉搏波速度(PWV)的关系。方法北京4个社区入选2285名18-96岁居民,平均年龄51±16岁,用问卷调查方法采集病史,自动示波测量仪检测PWV,同期化验血脂、肌酐、尿酸、血糖等指标,简化的MDRD公式估测肾小球滤过率(eGFR)。结果随着eGFR的下降,年龄、脉压、肌酐、餐后2h血糖、颈股PWV(cfPWV)均显著增高(P<0.001),但颈桡PWV(crPWV)组间比较无统计学意义(P=0.672)。整体人群中,cfPWV(r=-0.353,P<0.001)、颈踝PWV(caPWV,r=-0.167,P<0.001)与eGFR呈显著负相关,而crPWV与eGFR无相关关系(r=-0.033,P=0.115);经校正性别、年龄和收缩压后,仅cfPWV与eGFR呈微弱负相关(r=-0.047,P=0.026)。逐步回归显示,eGFR降低是女性cfPWV增高的独立危险因素(R2=0.495,P<0.001),而男性eGFR对cfPWV无显著影响。结论肾小球滤过率降低是女性肾功能正常或轻度减退人群动脉僵硬度增加的独立危险因素,主要引起中心动脉僵硬度的增加,与外周动脉硬化无明显关系。
Objective To investigate the relationship between glomerular filtration rate (eGFR) and traditional cardiovascular risk factors and pulse wave velocity (PWV) in normal or mildly-impaired community residents. Methods A total of 2285 residents aged 18-96 were enrolled in 4 communities in Beijing. Their average age was 51 ± 16 years old. Their medical history was collected by questionnaire survey. PWV was detected by automatic oscillometric measuring instrument. Blood lipids, creatinine, uric acid, The MDRD formula estimates glomerular filtration rate (eGFR). Results With the decrease of eGFR, age, pulse pressure, creatinine, postprandial 2h blood glucose, and carp PWV (cfPWV) were significantly increased (P <0.001), but there was no significant difference between PWV (crPWV) = 0.672). There was a significant negative correlation between cfPWV (r = -0.353, P <0.001) and eGFR in the ankle and ankle PWV (rP = -0.167, P <0.001), but no correlation between crPWV and eGFR , P = 0.115). After adjustment for gender, age and systolic blood pressure, only cfPWV was negatively correlated with eGFR (r = -0.047, P = 0.026). Stepwise regression showed that eGFR reduction was an independent risk factor for increased cfPWV in women (R2 = 0.495, P <0.001), whereas eGFR did not significantly affect cfPWV in men. Conclusions The decrease of glomerular filtration rate is an independent risk factor for arterial stiffness in female with normal renal function or with mild hypothyroidism. It mainly results in the increase of central arterial stiffness, but has no obvious relationship with peripheral arteriosclerosis.