新疆汉族与维吾尔族慢性肾脏病危险因素分析
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摘要
目的:探讨汉族与维吾尔族与慢性肾脏病(CKD)相关危险因素的异同。方法:收集2010年5月~2014年5月新疆医科大学第一附属医院体检中心体检者、肾病科、高血压科、内分泌科CKD患者总共17 520例,其中汉族CKD患者853例,汉族健康体检者899例,维吾尔族CKD患者297例,维吾尔族健康体检者291例。维吾尔族和汉组两民族患者的性别、年龄、肥胖、血脂异常、总胆固醇、三酰甘油、糖代谢紊乱、血尿酸、血压、蛋白尿等相关危险因素,分别进行单因素及多因素Logistic回归分析。结果:健康体检者汉族与维吾尔族相比,糖代谢紊乱比率较高(P<0.05),体重偏大、血压偏高、总胆固醇水平较高、血尿酸偏高(均P<0.05),CKD患者汉族与维吾尔族相比,糖代谢紊乱比率较高(P<0.05),血尿酸偏高、三酰甘油偏高、总胆固醇偏高(均P<0.05),年龄较小、血压偏低(均P<0.05)。经Logistic回归分析结果显示:糖代谢紊乱(OR=1.693,P<0.000)、高血压(OR=2.110,P<0.000)、尿酸(OR=1.349,P<0.05)与汉族CKD独立相关;高血压(OR=46.954,P<0.000)、血脂异常(OR=1.911,P=0.045)以及蛋白尿(OR=83.052,P<0.000)与维吾尔族CKD独立相关。结论:高血压是维汉CKD共同的独立危险因素。
Objective: To investigate the risk factors of chronic kidney disease( CKD) in the Han nationality and the Uygur nationality.Methods: From May 2014 to May 2010,there were 17520 cases of CKD patients in the First Affiliated Hospital of Xinjiang Medical University,Department of nephropathy,hypertension,Department of Endocrinology,including 853 patients with CKD,899 cases of healthy people,297 cases of Uygur CKD,291 cases of healthy physical examination.Sex,age,obesity,dyslipidemia,total cholesterol,total cholesterol,triglyceride,glucose metabolism disorder,blood uric acid,blood pressure,proteinuria and other related risk factors were analyzed by single factor and multi factor Logistic regression analysis.Results: Healthy physical examination compared with the Uygur nationality,the metabolic disorders,the body weight,blood pressure,high blood pressure,high blood uric acid of the Han nationality were higher( P < 0.05).Compared with the Uygur nationality in CKD patients,the metabolic disorders,the age,the body weight,blood pressure,high blood pressure,high blood uric acid of the Han nationality were higher( P < 0.05),Logistic regression analysis showed that the metabolic disorders( OR = 1.693,P < 0.000),the blood pressure( OR = 2.110,P <0.000),the uric acid( OR = 1.349,P < 0.05) were independently associated with CKD in Han nationality.The blood pressure( OR =46.954,P < 0.000),disorder of blood lipid( P = 0.045,OR = 1.911) and proteinuria( P < 0.000,OR = 83.052) in Uygur nationality.Conclusion: Hypertension is an independent risk factor for CKD in Uygur and Han nationality.
Objective: To investigate the risk factors of chronic kidney disease( CKD) in the Han nationality and the Uygur nationality.Methods: From May 2014 to May 2010,there were 17520 cases of CKD patients in the First Affiliated Hospital of Xinjiang Medical University,Department of nephropathy,hypertension,Department of Endocrinology,including 853 patients with CKD,899 cases of healthy people,297 cases of Uygur CKD,291 cases of healthy physical examination.Sex,age,obesity,dyslipidemia,total cholesterol,total cholesterol,triglyceride,glucose metabolism disorder,blood uric acid,blood pressure,proteinuria and other related risk factors were analyzed by single factor and multi factor Logistic regression analysis.Results: Healthy physical examination compared with the Uygur nationality,the metabolic disorders,the body weight,blood pressure,high blood pressure,high blood uric acid of the Han nationality were higher( P < 0.05).Compared with the Uygur nationality in CKD patients,the metabolic disorders,the age,the body weight,blood pressure,high blood pressure,high blood uric acid of the Han nationality were higher( P < 0.05),Logistic regression analysis showed that the metabolic disorders( OR = 1.693,P < 0.000),the blood pressure( OR = 2.110,P <0.000),the uric acid( OR = 1.349,P < 0.05) were independently associated with CKD in Han nationality.The blood pressure( OR =46.954,P < 0.000),disorder of blood lipid( P = 0.045,OR = 1.911) and proteinuria( P < 0.000,OR = 83.052) in Uygur nationality.Conclusion: Hypertension is an independent risk factor for CKD in Uygur and Han nationality.
引文
1.张路霞,王海燕.中国慢性肾脏病的现状及挑战---来自中国慢性肾脏病流行病学调查的启示.中华内科杂志,2012,51(7):497-498.
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9.赵慧,王玉,孟立强,等.中晚期老年慢性肾脏病患者血压控制与肾功能进展的关系.中华内科杂志,2015,54(3):181-187.
10.王玉,李晓梅.慢性肾脏病与高血压相关研究的热点问题.中国实用内科杂志,2007,27(10):814-818.
11.乐伟波,梁少珊,邓康平,等.1 126例中国汉族成人Ig A肾病患者长期预后及危险因素分析.肾脏病与透析肾移植杂志,2011,20(2):101-108.
12.Kawashima M,Wada K,Ohm H,et al.Association between asymptomatie hyperuricemia and new-omet chronic kidney disease in Japanese male workei.s:a long-term retrospective cohort study BMC.Nephrology,2011,2(12):31-38.
13.孙玉萍,姚华,艾木拉江,等.汉族和维吾尔族居民血尿酸及高尿酸血症分析.中国公共卫生,2008,24(2):185-187.
14.张继强,陈卫东,尹晓丽.慢性肾脏病患者血脂变化先关因素分析.临床肾病杂志,2012,12(3):110-112.
15.Iseki K.Body mass index and the risk of chronic renal failure:the Asian Experience.Contrib Nephn,2006,151(1):42-56.
16.Ballantyne GH,Gumbs A,Mod Iin IM.Changes in insulin resistance fol-lowing bariatric surgery and the adipoinsular axis:role of the adipocy to kines,leptin,adiponeetin and resistin.Obes Surg,2005,15(5):692-699.
17.高春燕,李莉,殷小红,等.不同性别、民族健康成年人体质量指数与体脂百分比的相关性及应用评价.国际检验医学杂志,2015,36(3):338-340.
18.Piotr W,Marek S,Zbigniew N,et al.Insulin resistance as a novel therapeutic target in patients with chronic kidney disease treated with dialysis.Pol Arch Med Wewm,2010,120(1):54-57.
2.Coresh J,Selvin E,Lesley A,et al.Prevalence of chronic kidney disease in the United States.JAMA,2007,298(17):2038-2047.
3.Genut S,Alberti KG,Bennett P,et al.Follow up report on the diagnosis of diabetes mellitus.Diabetes Care,2003,26(11):3160-3167.
4.中国成人血脂异常防治指南制定联合委员会.中国成人血脂异常防治指南.中华心血管杂志,2007,35(5):390-413.
5.陈春明,孔灵芝.中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南.北京:人民卫生出版社,2006.21-22.
6.迪力木拉提,李增录,刘健,等.新疆墨玉县农村维吾尔族成人慢性肾脏病流行病学调查.中华肾脏病杂志,2009,25(8):607-612.
7.徐潇漪,多景华,罗洋,等.内蒙古呼伦贝尔地区成人慢性肾脏病流行病学调查.中华肾脏病杂志,2010,26(6):422-426.
8.罗洋,谌贻璞,李文歌,等.云南省西双版纳地区成人慢性肾脏病流行病学调查.中华肾脏病杂志,2008,24(9):609-613.
9.赵慧,王玉,孟立强,等.中晚期老年慢性肾脏病患者血压控制与肾功能进展的关系.中华内科杂志,2015,54(3):181-187.
10.王玉,李晓梅.慢性肾脏病与高血压相关研究的热点问题.中国实用内科杂志,2007,27(10):814-818.
11.乐伟波,梁少珊,邓康平,等.1 126例中国汉族成人Ig A肾病患者长期预后及危险因素分析.肾脏病与透析肾移植杂志,2011,20(2):101-108.
12.Kawashima M,Wada K,Ohm H,et al.Association between asymptomatie hyperuricemia and new-omet chronic kidney disease in Japanese male workei.s:a long-term retrospective cohort study BMC.Nephrology,2011,2(12):31-38.
13.孙玉萍,姚华,艾木拉江,等.汉族和维吾尔族居民血尿酸及高尿酸血症分析.中国公共卫生,2008,24(2):185-187.
14.张继强,陈卫东,尹晓丽.慢性肾脏病患者血脂变化先关因素分析.临床肾病杂志,2012,12(3):110-112.
15.Iseki K.Body mass index and the risk of chronic renal failure:the Asian Experience.Contrib Nephn,2006,151(1):42-56.
16.Ballantyne GH,Gumbs A,Mod Iin IM.Changes in insulin resistance fol-lowing bariatric surgery and the adipoinsular axis:role of the adipocy to kines,leptin,adiponeetin and resistin.Obes Surg,2005,15(5):692-699.
17.高春燕,李莉,殷小红,等.不同性别、民族健康成年人体质量指数与体脂百分比的相关性及应用评价.国际检验医学杂志,2015,36(3):338-340.
18.Piotr W,Marek S,Zbigniew N,et al.Insulin resistance as a novel therapeutic target in patients with chronic kidney disease treated with dialysis.Pol Arch Med Wewm,2010,120(1):54-57.