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

doi:10.3877/cma.j.issn.2095-3216.2019.02.003

Abstract

Abstract:

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.

Key words: Healthy population, eGFR, Nutrition, Inflammation, Sex hormone

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]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(02): 62-66.

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Figures/Tables 6

References 16

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项目	数据	项目	数据
例数(例)	520	热量[(kj/(kg·d)]	148.64(124.53，178.40)
男性(例)	224	蛋白质[g/(kg·d)]	1.10(0.91，1.36)
年龄(岁)	57.00±14.69	脂肪[g/(kg·d)]	1.30(1.00，1.60)
体质量指数(kg/m²)	23.89±2.97	碳水化合物[g/(kg·d)]	4.63(3.67，5.77)
平均动脉压(mmHg)	93.33(86.67，100)	纤维素[g/(kg·d)]	0.20(0.15，0.26)
eGFR [ml/(min·1.73 m²)]	97.76±19.36	维生素E (mg/d)	29.17(22.54，39.40)
血红蛋白(g/L)	144.0(135.00，155.00)	维生素C (mg/d)	125.07(88.26，188.30)
空腹血糖(mmol/L)	5.28(4.86，5.68)	硫胺素(mg/d)	1.03(0.84，1.26)
血清白蛋白(g/L)	45.15(42.70，47.8)	尼克酸(mg/d)	13.52(10.91，17.15)
血清转铁蛋白(g/L)	2.13(1.90，2.36)	钙(mg/d)	836.15(654.24，1054.53)
超敏CRP (mg/L)	0.95(0.44，2.05)	磷(mg/d)	1233.01(1009.24，1459.74)
白介素-6 (ng/L)	2.04(1.42，3.08)	铁(mg/d)	23.48(19.59，28.55)
睾酮(μg/L)	0.46(0.23，4.6)	镁(mg/d)	376.72(308.92，457.27)
雌二醇(ng/L)	35.00(22.00，55.75)	锌(mg/d)	13.41(11.11，16.29)
黄体酮(μg/L)	0.64(0.44，0.99)	?	?

项目	数据	项目	数据
例数(例)	520	热量[(kj/(kg·d)]	148.64(124.53，178.40)
男性(例)	224	蛋白质[g/(kg·d)]	1.10(0.91，1.36)
年龄(岁)	57.00±14.69	脂肪[g/(kg·d)]	1.30(1.00，1.60)
体质量指数(kg/m²)	23.89±2.97	碳水化合物[g/(kg·d)]	4.63(3.67，5.77)
平均动脉压(mmHg)	93.33(86.67，100)	纤维素[g/(kg·d)]	0.20(0.15，0.26)
eGFR [ml/(min·1.73 m²)]	97.76±19.36	维生素E (mg/d)	29.17(22.54，39.40)
血红蛋白(g/L)	144.0(135.00，155.00)	维生素C (mg/d)	125.07(88.26，188.30)
空腹血糖(mmol/L)	5.28(4.86，5.68)	硫胺素(mg/d)	1.03(0.84，1.26)
血清白蛋白(g/L)	45.15(42.70，47.8)	尼克酸(mg/d)	13.52(10.91，17.15)
血清转铁蛋白(g/L)	2.13(1.90，2.36)	钙(mg/d)	836.15(654.24，1054.53)
超敏CRP (mg/L)	0.95(0.44，2.05)	磷(mg/d)	1233.01(1009.24，1459.74)
白介素-6 (ng/L)	2.04(1.42，3.08)	铁(mg/d)	23.48(19.59，28.55)
睾酮(μg/L)	0.46(0.23，4.6)	镁(mg/d)	376.72(308.92，457.27)
雌二醇(ng/L)	35.00(22.00，55.75)	锌(mg/d)	13.41(11.11，16.29)
黄体酮(μg/L)	0.64(0.44，0.99)	?	?

年龄组	总体		男性		女性
年龄组	例数	eGFR	例数	eGFR	例数	eGFR
<35岁	25	131.04±13.11	8	121.63±11.76	17	135.47±11.50
35～44岁	120	114.21±12.54	51	113.69±15.00	69	114.59±10.47
45～54岁	102	102.48±12.12	42	102.93±11.30	60	102.17±12.75
55～64岁	86	94.51±9.87	37	95.38±10.29	49	93.86±9.61
65～74岁	119	86.09±12.19	50	85.48±12.57	69	86.54±11.98
≥75岁	68	73.93±13.90	36	75.22±14.34	32	72.47±13.45

年龄组	总体		男性		女性
年龄组	例数	eGFR	例数	eGFR	例数	eGFR
<35岁	25	131.04±13.11	8	121.63±11.76	17	135.47±11.50
35～44岁	120	114.21±12.54	51	113.69±15.00	69	114.59±10.47
45～54岁	102	102.48±12.12	42	102.93±11.30	60	102.17±12.75
55～64岁	86	94.51±9.87	37	95.38±10.29	49	93.86±9.61
65～74岁	119	86.09±12.19	50	85.48±12.57	69	86.54±11.98
≥75岁	68	73.93±13.90	36	75.22±14.34	32	72.47±13.45

临床指标	与eGFR的相关性		临床指标	与eGFR的相关性
临床指标	r值	P值	临床指标	r值	P值
体质量指数(kg/m²)	－0.132	0.002	脂肪摄入量[ g/(kg·d)]	0.055	0.208
平均动脉压(mmHg)	－0.322	<0.001	碳水化合物[ g/(kg·d)]	0.012	0.777
血红蛋白(g/L)	－0.019	0.671	纤维素[ g/(kg·d)]	－0.102	0.020
空腹血糖(mmol/L)	－0.120	0.006	维生素E (mg/d)	－0.067	0.126
血清白蛋白(g/L)	0.289	<0.001	维生素C (mg/d)	－0.055	0.214
血清转铁蛋白(g/L)	0.264	<0.001	硫胺素(mg/d)	－0.069	0.118
超敏CRP (mg/L)	－0.249	<0.001	尼克酸(mg/d)	0.078	0.075
白介素－6(ng/L)	－0.322	<0.001	钙(mg/d)	－0.065	0.138
睾酮(μg/L)	0.049	0.269	磷(mg/d)	－0.017	0.692
雌二醇(ng/L)	0.312	<0.001	铁(mg/d)	－0.04	0.361
黄体酮(μg/L)	0.298	<0.001	镁(mg/d)	－0.048	0.273
热量[kj/(kg·d)]	0.054	0.217	锌(mg/d)	0.012	0.779
蛋白质[g/(kg·d)]	0.027	0.534	?	?	?

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