60岁及以上人群连续代谢综合征评分与肾小球滤过率的关系研究
Correlation between the Continuous Metabolic Syndrome Score and Glomerular Filtration Rate in Individuals Aged 60 and Above
张睿 1王为强 2卢鸿润 1李佳禛 1赵钰1
作者信息
- 1. 230000 安徽省合肥市，安徽医科大学;234000 安徽省宿州市，安徽医科大学附属宿州医院 安徽省宿州市立医院全科医学科
- 2. 234000 安徽省宿州市，安徽医科大学附属宿州医院 安徽省宿州市立医院全科医学科
- 折叠
摘要
背景 代谢综合征（MetS）严重影响个体的身体健康，尤其是对脏器的损害。连续代谢综合征评分（cMetS）是基于腰围（WC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、平均动脉压（MAP）及空腹血糖（FPG）5项代谢指标进行加权计算而成的评分标准，但目前对于cMetS与肾脏功能的相关性研究相对较少。目的 探讨cMetS早期筛查慢性肾脏病（CKD）的有效性，并通过控制相关因素降低目标人群患CKD的风险。方法 2017—2021年，本项目在安徽省12个县市的社区体检居民中，针对心血管疾病高危的60岁以上老年人，进行早期筛查，共筛选收集了2 049份数据。将研究对象依据估算肾小球滤过率（eGFR）水平进行分组：eGFR<90 mL·min-1·（1.73 m2）-1为低滤过率组，eGFR≥90 mL·min-1·（1.73 m2）-1为正常组。采用多因素Logistic回归分析探讨cMetS四分位水平与eGFR降低风险的关系。结果 低滤过率组（n=927）的年龄、体质量、BMI、WC、收缩压（SBP）、FPG、血肌酐（Scr）、尿素氮（BUN）、TG、腰高比（WHtR）、腰高比0.5（WHT.5R）、身体圆度指数（BRI）及cMetS均高于正常组（n=1 122），差异有统计学意义（P<0.05）。依据cMetS四分位间距分为Q1~Q4组，Q1组-4.40~<-0.18分，Q2组-0.18~<0.30分，Q3组0.30~<0.79分，Q4组0.79~4.96分。4组的BH、体质量、BMI、WC、SBP、DBP、MAP、FPG、Scr、TC、TG、低密度脂蛋白胆固醇（LDL-C）、WHtR、WHt.5R、BRI随cMeTS水平升高而升高，BUN、HDL-C、eGFR随cMeTS水平升高而降低（P<0.05）。与cMetS Q1组相比，Q2、Q3、Q4组肾小球滤过率降低的风险升高（OR=1.462、1.656、1.652，P<0.05），与BMI M1组（16.51~23.19 kg/m2）比较，M2（23.19~25.31 kg/m2）、M3（25.31~27.61 kg/m2）、M4组（27.31~40.89 kg/m2）肾小球滤过率降低的风险升高（OR=1.373、1.328、1.385，P<0.05）。结论 在60岁及以上人群中，随着cMeTs水平升高，年龄增大、BMI增大、eGFR下降，cMetS升高和BMI升高是肾小球滤过率下降的独立危险因素。随着年龄的增长，肾脏的功能逐渐减退，而MetS的存在会进一步加速这种衰退。对于这一目标人群，需要进行早期的干预，以延缓肾功能的恶化。
Abstract
BackgroundMetabolic syndromeMetSsignificantly impacts individuals' physical healthparticularly causing organ damage. The continuous metabolic syndrome scorecMetSis a weighted composite score based on five metabolic indicatorswaist circumferenceWCtriglyceridesTGhigh-density lipoprotein cholesterolHDL-Cmean arterial pressureMAPand fasting plasma glucoseFPG. Howeverresearch on the correlation between cMetS and renal function remains relatively scarce. ObjectiveTo investigate the effectiveness of cMetS in early screening for chronic kidney diseaseCKDand to reduce the risk of CKD in the target population by controlling relevant factors. MethodsFrom 2017 to 2021this project screened and collected data from 2049 elderly individualsaged 60 yearswith high cardiovascular risks during community-based health examinations across 12 counties/cities in Anhui Province. Participants were stratified by estimated glomerular filtration rateeGFRthe low-filtration groupeGFR <90 mLmin-11.73 m2 -1and the normal groupeGFR 90 mLmin-11.73 m2 -1. Multivariate logistic regression was employed to analyze the correlation between cMetS quartiles and the risk of reduced eGFR. ResultsPatients in the low-filtration groupn=927showed significantly older ageand higher body weightbody mass indexBMIwaist circumferenceWCsystolic blood pressureSBPfasting plasma glucoseFPGserum creatinineScrblood urea nitrogenBUNtriglyceridesTGwaist-to-height ratio WHtRWHtR cut-off=0.5WHt.5Rbody roundness indexBRIand cMetS than the normal groupn=1 122P<0.05. Stratified by cMetS quartilesfour groups were assigned as followsQ1=-4.40 to <-0.18Q2=-0.18 to <0.30Q3=0.30 to <0.79Q40.79 to 4.96. The body hightBHbody massBMIWCSBPDBPMAPFPGScrTCTGlow-density lipoprotein cholesterolLDL-CWHtRWHt.5Rand BRI in the four groups increased with the increasing cMeTS levelswhile BUNHDL-Cand eGFR decreased with the increasing cMeTS levelsP<0.05. Compared with the cMetS Q1 groupthe risk of decreased glomerular filtration rate increased in Q2Q3and Q4 groupsOR=1.4621.656and 1.652respectivelyP<0.05. Compared with the BMI M1 group16.51-23.19 kg/m2 the risk of decreased glomerular filtration rate in M223.19-25.31 kg/m2 M325.31-27.61 kg/m2 and M4 groups27.31-40.89 kg/m2 significantly increased OR=1.3731.328and 1.385respectivelyP<0.05. ConclusionAmong older adults of 60 years and aboveage and BMI increaseand eGFR decreases with the increasing cMeTs levels. Elevated cMetS and BMI are independent risk factors for the decreased glomerular filtration rate. Renal function gradually declines with agingwhich can be accelerated by MetS. For older adults of 60 years and aboveearly intervention is needed to delay the deterioration of renal function.关键词
代谢综合征/连续代谢综合征评分/肾小球滤过率/慢性肾脏病/安徽省引用本文复制引用
张睿,王为强,卢鸿润,李佳禛,赵钰.60岁及以上人群连续代谢综合征评分与肾小球滤过率的关系研究[EB/OL].(2026-01-09)[2026-01-12].https://chinaxiv.org/abs/202601.00109.学科分类
医学研究方法/基础医学/临床医学
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