估算阿布扎比人口的特定年龄和性别肾小球滤过率及其与死亡率和动脉粥样硬化性心血管疾病结果的关系。回顾性队列研究

L. Alketbi, Yousef Boobes, N. Nagelkerke, H. Aleissaee, N. AlShamsi, M. Almansoori, Ahmed Hemaid, M. AlDobaee, Noura AlAlawi, R. AlKetbi, T. Fahmawee, B. AlHashaikeh, A. AlAzeezi, F. Shuaib, J. Alnuaimi, E. Mahmoud, N. AlAhbabi, Bachar Afandi, Retrospective Cohort Study
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The cohort was reevaluated in 2023 for mortality and cardiovascular outcomes. Reference eGFR percentiles were estimated from subjects without comorbidities using the LMS method. Results The reference percentiles of normal eGFR values showed a marked decrease with age, with small sex differences in the reference percentile distribution. A prognostic definition of renal hyperfiltration (RH) is suggested by the observation that subjects in the 97th percentile had a significantly higher incidence of ASCVD, although not statistically significant, in terms of mortality rate. Older age, female sex, history of ASCVD, history of hypertension, being treated for hypertension, lower diastolic blood pressure, higher systolic blood pressure, lower HDL, higher HA1C, and higher vitamin D were significantly associated with lower eGFR percentiles. 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引用次数: 0

摘要

肾小球滤过率(eGFR)异常对各种不良后果的影响已得到充分研究;然而,阿拉伯联合酋长国(UAE)与世界上许多其他地区一样,在这一领域的研究仍然不足。方法 该回顾性队列研究估算了阿布扎比人口中特定年龄和性别的肾小球滤过率(eGFR)及其与死亡率和动脉粥样硬化性心血管疾病(ASCVD)结果的关系。该队列由 2011 年至 2013 年参加全国心血管疾病筛查的 8699 人组成。2023 年对该队列进行了死亡率和心血管后果的重新评估。采用 LMS 方法从无合并症的受试者中估算出 eGFR 参考百分位数。结果 正常 eGFR 值的参考百分位数随着年龄的增长而明显下降,参考百分位数分布的性别差异较小。肾脏高滤过率(RH)的预后定义是通过观察发现的,位于第 97 百分位数的受试者发生 ASCVD 的几率明显较高,尽管在死亡率方面没有统计学意义。年龄较大、性别为女性、有 ASCVD 病史、高血压病史、正在接受高血压治疗、舒张压较低、收缩压较高、高密度脂蛋白较低、HA1C 较高和维生素 D 较高与较低的 eGFR 百分位数显著相关。在 RH 范围内的两个类别,即第 95 和 97 百分位数中,受试者的糖尿病患病率明显较高;他们是年龄较大的吸烟者,具有较高的体重指数、较高的 HA1C、较高的 HDL 和较低的维生素 D,并且更可能是男性,具有较高的体力活动量和较低的冠心病患病率。结论 按年龄和性别分列的 eGFR 分布情况对阿布扎比的临床决策很有价值,对整个阿拉伯人口也很有可能有价值。虽然在该队列中,eGFR 的第 95 百分位数显示出较高但不显著的风险,但第 97 百分位数与 ASCVD 有显著相关性,甚至高于 eGFR 第 10 百分位数以下的受试者。这项研究为我们深入了解阿布扎比人口中不同 eGFR 百分位数的患病率和相关风险因素提供了重要依据。研究结果突出表明,有必要采取有针对性的干预措施,以解决可改变的风险因素,并防止这一高风险人群的肾脏损伤恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estimation of age and sex specific Glomerular Filtration Rate in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular outcome. A Retrospective Cohort Study
The impact of abnormal Glomerular Filtration Rate (eGFR) on various adverse outcomes has been well studied; however, the United Arab Emirates (UAE), like many other regions in the world, remains understudied in this area. Method This retrospective cohort study estimates the age and sex-specific Glomerular Filtration Rate (eGFR) in the Abu Dhabi population and its association with mortality and Atherosclerotic cardiovascular (ASCVD) outcomes. The cohort of 8699 participants in a national cardiovascular disease screening from 2011 to 2013. The cohort was reevaluated in 2023 for mortality and cardiovascular outcomes. Reference eGFR percentiles were estimated from subjects without comorbidities using the LMS method. Results The reference percentiles of normal eGFR values showed a marked decrease with age, with small sex differences in the reference percentile distribution. A prognostic definition of renal hyperfiltration (RH) is suggested by the observation that subjects in the 97th percentile had a significantly higher incidence of ASCVD, although not statistically significant, in terms of mortality rate. Older age, female sex, history of ASCVD, history of hypertension, being treated for hypertension, lower diastolic blood pressure, higher systolic blood pressure, lower HDL, higher HA1C, and higher vitamin D were significantly associated with lower eGFR percentiles. Subjects in the two categories within the RH range, the 95th and 97th percentiles, had a significantly higher prevalence of diabetes; they are older smokers with higher BMI, higher HA1C, higher HDL, lower vitamin D, and more likely to be males, with higher physical activity and have a lower prevalence of CHD. Conclusion The distribution of eGFR by age and sex is valuable for clinical decision-making in Abu Dhabi and likely for the Arab population in general. Although the 95th percentile of eGFR in this cohort showed a higher but nonsignificant risk, the 97th percentile is significantly associated with ASCVD, even more than subjects in the less than 10th eGFR percentile. This study provides important insights into the prevalence and risk factors associated with different eGFR percentiles in the Abu Dhabi population. The findings underscore the need for targeted interventions to address modifiable risk factors and prevent the progression of renal damage in this high-risk population.
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