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目的探讨肾功能轻度下降与代谢综合征(MS)及其组分的关联。方法对2009年中国健康与营养调查数据库中7 309名研究对象资料进行分析,MS诊断采用中华医学会糖尿病分会制定的标准,肾脏损伤程度采用MDRD公式估算的肾小球滤过率(e GFR)作为判定指标,比较e GFR轻度下降与正常组各指标差异,分析肾功能轻度损伤与MS的关系。结果共诊断出MS患者2 034例,患病率为27.83%。MS患者中e GFR轻度下降1 508例(74.14%),非MS患者e GFR轻度下降3 357例(63.64%),MS患者e GFR轻度下降比例高于非MS患者(P<0.05),且e GFR轻度下降比例随代谢异常组分的增加呈上升趋势(P<0.05)。Logistics回归分析结果显示,高空腹血糖(OR=1.22,95%CI:1.06~1.42)、高三酰甘油(OR=1.21,95%CI:1.05~1.38)和低高密度脂蛋白胆固醇(OR=1.23,95%CI:1.06~1.41)是e GFR轻度下降的危险因素。结论 MS及其组分高空腹血糖、高三酰甘油和低高密度脂蛋白胆固醇是发生肾功能轻度下降的危险因素,应对MS人群的肾功能进行重点筛查。
Objective To investigate the association between mild decline of renal function and metabolic syndrome (MS) and its components. Methods The data of 7 309 subjects in the 2009 China Health and Nutrition Survey database were analyzed. The diagnosis of MS was based on the criteria established by the Diabetes Branch of Chinese Medical Association. The degree of renal damage was estimated by the MDRD formula of glomerular filtration rate (e GFR) As a criterion, the difference between mild decline of eGFR and normal group was compared, and the relationship between mild renal impairment and MS was analyzed. Results A total of 2 034 MS patients were diagnosed with a prevalence of 27.83%. There was a slight decrease of eGFR in MS patients (1 508 cases, 74.14%), a slight decrease of eGFR in non-MS patients (3557 cases, 63.64%), and a mild decrease of eGFR in MS patients (P 0.05) , And the slight decrease of e GFR increased with the increase of metabolic abnormalities (P <0.05). The logistic regression analysis showed that there was no significant difference between high fasting blood glucose (OR = 1.22, 95% CI: 1.06-1.42), high triglyceride (OR = 1.21, 95% CI: 1.05-1.38) and low-density lipoprotein cholesterol , 95% CI: 1.06 to 1.41) were risk factors for mild decline in eGFR. Conclusion MS and its components of fasting blood glucose, high triglycerides and low-density lipoprotein cholesterol are risk factors for mild decline in renal function, MS population should focus on the screening of renal function.