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中华肾病研究电子杂志 ›› 2019, Vol. 08 ›› Issue (02) : 62 -66. doi: 10.3877/cma.j.issn.2095-3216.2019.02.003

所属专题: 文献

论著

健康人群肾小球滤过率的增龄变化及其与营养、炎症和性激素的关联性研究
张恒达1, 林洪丽2, 韩璐璐3, 席春生1, 乔晞1, 刘秀娟1, 蔡广研1, 孙雪峰1,(), 陈香美1   
  1. 1. 100853 北京,解放军总医院肾脏病科、解放军肾脏病研究所、肾脏疾病国家重点实验室(2011DAV00088)、国家慢性肾病临床医学研究中心,肾脏疾病研究北京市重点实验室
    2. 116011 大连,大连医科大学附属第一医院肾内科
    3. 110004 沈阳,中国医科大学附属盛京医院老年病科
  • 收稿日期:2018-12-19 出版日期:2019-04-28
  • 通信作者: 孙雪峰
  • 基金资助:
    国家"973"项目(2013CB530800); 国家自然科学基金面上项目(81870463)

Age-related eGFR change in healthy people and its association with nutrition, inflammation, and sex hormones

Hengda Zhang1, Hongli Lin2, Lulu Han3, Chunsheng Xi1, Xi Qiao1, Xiujuan Liu1, Guangyan Cai1, Xuefeng Sun1,(), Xiangmei Chen1   

  1. 1. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing 100853
    2. Department of Nephrology, The First Hospital Affiliated to Dalian Medical University, Dalian 116011
    3. Department of Geriatrics, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004; China
  • Received:2018-12-19 Published:2019-04-28
  • Corresponding author: Xuefeng Sun
  • About author:
    Corresponding author: Sun Xuefeng, Email:
引用本文:

张恒达, 林洪丽, 韩璐璐, 席春生, 乔晞, 刘秀娟, 蔡广研, 孙雪峰, 陈香美. 健康人群肾小球滤过率的增龄变化及其与营养、炎症和性激素的关联性研究[J/OL]. 中华肾病研究电子杂志, 2019, 08(02): 62-66.

Hengda Zhang, Hongli Lin, Lulu Han, Chunsheng Xi, Xi Qiao, Xiujuan Liu, Guangyan Cai, Xuefeng Sun, Xiangmei Chen. Age-related eGFR change in healthy people and its association with nutrition, inflammation, and sex hormones[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(02): 62-66.

目的

分析估算肾小球滤过率(eGFR)的增龄变化及其与营养、炎症和性激素的关联,为深入研究和临床防治增龄性eGFR减退提供线索。

方法

多中心、横断面的大样本流行病学调查,共纳入健康研究对象520名(男224名,女296名),依年龄分为成年组(年龄<65岁)和老年组(年龄≥65岁),回顾性膳食调查计算热量和营养素摄入量,利用CKD-EPI公式计算eGFR;同时检测炎症、性激素及生化指标,多元线性回归分析总体人群、成人组和老年组的各项指标与eGFR的关联性。

结果

①无论男性还是女性,eGFR均伴随增龄下降(P<0.05),男女之间无明显差别(P>0.05);②成人女性eGFR与睾酮、雌二醇、黄体酮均呈正相关(P<0.05);③eGFR的独立影响因素,总体人群为体质量指数、平均动脉压、血清白蛋白、血清转铁蛋白、白细胞介素-6(IL-6)、雌二醇、黄体酮、纤维摄入量、硫胺素摄入量及尼克酸摄入量;成人组为平均动脉压、血清白蛋白、高敏C反应蛋白、雌二醇及镁摄入量;老年组仅为IL-6。

结论

伴随增龄eGFR进行性降低,炎症状态是健康人群、特别是老年人eGFR的重要影响因素,成年女性eGFR与性激素明显相关。

Objective

To analyze the age-related changes in estimate glomerular filtration rate (eGFR) and its association with nutrition, inflammation and sex hormones for the purpose of providing clues for in-depth research on and clinical prevention and treatment of age-related eGFR decline.

Methods

A multi-center, cross-sectional large sample epidemiological survey was performed. A total of 520 healthy individuals (224 males and 296 females) were enrolled and divided into adult group (age < 65 years) and elderly group (age ≥65 years). The calorie and nutrient intake were calculated through retrospective dietary investigation. The eGFR was calculated with the chronic kidney disease epidemiology collaboration (CKD-EPI) formula, and the changes of inflammatory cytokines, sex hormones, and biochemical indexes were also detected. The multivariate linear regression analysis was used to analyze the correlation between eGFR and those indexes of the overall population, adult group, and elderly group.

Results

(1) In both the males and females, eGFR decreased with age (P<0.01), and no significant difference was found between the males and females (P>0.05). (2) A significant positive correlation was found between eGFR and testosterone, estradiol, or progesterone in the adult women (P<0.01). (3) The independent influencing factors of eGFR were body mass index (BMI), mean arterial pressure, serum albumin, serum transferrin, interleukin-6 (IL-6), estradiol, progesterone, fiber intake, thiamine, and niacin intake in the overall population. The independent influencing factors of eGFR were mean arterial pressure, serum albumin, high sensitivity C reactive protein (hsCRP), estradiol, and magnesium intake in the adult group, and were only IL-6 in the elderly group.

Conclusion

With the progressive decrease of eGFR with age, the inflammatory status was an important influencing factor in the healthy population, especially in the elderly group. And there was a significant correlation between eGFR and sex hormones in the adult women.

表1 研究对象的临床资料
表2 不同性别eGFR的增龄变化[ml/(min·1.73 m2)]
表3 总体人群eGFR与各项临床指标的单因素相关性
表4 成人组、老年组eGFR与各项临床指标的单因素相关性
表5 成年组男性、女性eGFR与性激素的单因素相关分析
表6 eGFR 的多因素相关分析
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