Association between venous fasting blood glucose and estimated glomerular filtration rate among adults in Beijing-Tianjin-Hebei Region
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摘要:
目的 探索京津冀地区成人静脉FPG水平与估算肾小球滤过率(estimated glomerular filtration rate, eGFR)的关系，进而为慢性肾脏病(chronic kidney disease, CKD)的早期发现和干预提供科学依据。 方法 收集京津冀地区成人自然人群的人口学特征信息、现病史、行为和生活方式，并采集空腹静脉血液检测GLU、血脂和肾功能。用CKD流行病学合作研究公式(chronic kindey disease epidemiology collaboration, CKD-EPI)估算每个受试者的eGFR，采用多重线性回归分析模型分析FPG水平和eGFR的关系。 结果 共分析9 446人，在多重线性回归分析模型中，控制人口学特征和行为习惯及慢性病史等因素对eGFR的影响后，FPG和Log(eGFR)呈负相关(β=-0.002, P＜0.001)。 结论 静脉FPG水平与eGFR呈线性相关，FPG的增高与eGFR下降的风险相关。 Abstract:Objective To explore the relationship between venous fasting plasma glucose (FPG) and estimated glomerular filtration rate (eGFR) among adults in Beijing-Tianjin-Hebei Region, to provide a scientific basis for the early detection and intervention of chronic kidney disease (CKD). Methods The demographic characteristics, medical history, behavior and lifestyle of adult attendees at physical examination center were collected, and fasting venous blood samples were collected to detect blood glucose, blood lipids and renal function. The eGFR of each subject was estimated by chronic kindey disease epidemiology collaboration (CKD-EPI) equation. The relationship between FPG level and eGFR was analyzed by multiple linear regression. Results A total of 9 446 people were analyzed. After controlling the effects of demographic characteristics, behavior habits and chronic medical history on eGFR in the multiple linear regression model, there was a negative correlation between FPG and Log(eGFR) (β=-0.002, P < 0.001). Conclusion There is a linear correlation between venous FPG and eGFR, high FPG increases the odds of decreased eGFR. -
Key words:
- Fasting blood glucose /
- Glomerular filtration rate /
- Renal function injury
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表 1 人口学特征、生活方式和现病史对eGFR影响的单因素分析[n(%)]
Table 1. The associations of sociodemographic, lifestyle factors, history of chronic disease and eGFR [n(%)]
变量 例数 Log
(eGFR)eGFR
(x±s)U/F值 P值 性别 -1.989 0.047 男 5 075(53.7) 1.979 96.77±16.16 女 4 371(46.3) 1.975 96.07±17.75 民族 -0.867 0.386 汉族 9 263(98.1) 1.977 96.47±16.92 其他 183(1.9) 1.972 95.27±16.75 文化程度 -6.67 < 0.001 高中及以下 3 753(39.7) 1.970 95.14.±18.27 大专及以上 5 693(60.3) 1.982 97.31±15.90 婚姻状况 1.997 < 0.001 未婚 623(6.6) 2.019 105.87±16.55 已婚 8 683(91.9) 1.975 95.94±16.65 离异或丧偶 140(1.5) 1.921 85.73±19.47 高血压 -21.667 < 0.001 是 1 746(18.5) 1.986 88.55±17.55 否 7 700(81.5) 1.938 98.24±16.24 T2DM -13.525 < 0.001 是 625(6.6) 1.980 87.55±15.68 否 8 821(93.4) 1.934 97.08±16.82 吸烟史 1.036 0.239 不吸烟 6 772(71.7) 1.977 96.40±17.41 吸烟 2 026(21.4) 1.988 98.49±15.33 戒烟 648(6.9) 1.950 90.52±14.86 饮酒史 1.100 0.028 不饮酒 6 877(72.8) 1.976 96.33±17.29 饮酒 2 311(24.5) 1.983 97.38±15.67 戒酒 258(2.7) 1.950 91.12±16.61 锻炼情况 1.298 < 0.001 不锻炼 3 502(37.1) 1.989 99.05±16.84 偶尔 771(8.2) 1.985 98.15±16.56 经常 5 173(54.8) 1.968 94.43±16.75 睡眠质量 -0.986 0.324 好 8 356(88.5) 1.977 96.50±16.96 差 1 090(11.5) 1.975 96.01±16.61 体力劳动 1.603 < 0.001 轻度 7 364(78.0) 1.969 94.68±17.08 中度 1 799(19.0) 2.007 102.70±14.95 重度 283(3.0) 2.008 102.75±13.16 每日久坐时长(h) -6.934 < 0.001 < 4 3 827(40.5) 1.983 97.62±15.95 ≥4 5 619(59.5) 1.973 95.64±17.50 
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表 2 主要分类自变量赋值情况
Table 2. Evaluation of major categories of the independent variables
变量名称 变量描述 性别 0=男，1=女 民族 0=汉族，1=其他 文化程度 0=高中及以下，1=大专及以上 婚姻状况 0=未婚，1=已婚，2=离异或丧偶 高血压 0=未患高血压，1=患有高血压 T2DM 0=未患T2DM，1=患有T2DM 吸烟史 0=不吸烟，1=吸烟，2=戒烟 饮酒史 0=不饮酒，1=饮酒，2=戒酒 锻炼情况 0=不锻炼，1=偶尔，2=经常 睡眠质量 0=好，1=差 体力劳动 0=轻度，1=中度，2=重度 每日久坐时长 0= < 4 h，1=≥4 h
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表 3 连续变量对eGFR影响的简单线性回归分析
Table 3. Simple linear regression of the effect of continuous variables on eGFR
连续变量 β值 统计量 P值 年龄(岁) 0.072 6.507 < 0.001 BMI(kg/m2) -0.021 -1.740 0.082 SBP(mm Hg) -0.224 -13.989 < 0.001 DBP(mm Hg) 0.101 6.413 < 0.001 FPG(mmol/L) -0.090 -7.711 < 0.001 TC(mmol/L) -0.121 -7.848 < 0.001 TG(mmol/L) 0.064 5.298 < 0.001 HDL-C(mmol/L) -0.012 -1.001 0.317 LDL-C(mmol/L) 0.024 1.606 0.108
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表 4 eGFR相关因素的多重线性回归分析
Table 4. Multiple linear regression of factors related to eGFR
变量 β(95% CI)值 sx β’值 t值 P值 常量 2.054(2.036~2.071) 0.009 234.052 < 0.001 FPG(mmol/L) -0.002(-0.004~-0.001) 0.001 -0.045 -3.349 0.001 性别 -0.011(-0.015~-0.007) 0.002 -0.068 -5.306 < 0.001 年龄(岁) 0.001(0.000~0.001) 0.000 0.097 8.737 < 0.001 婚姻 -0.039(-0.045~-0.033) 0.003 -0.134 -12.484 < 0.001 文化程度 0.025(0.022~0.029) 0.002 0.153 13.783 < 0.001 高血压(mm Hg) -0.030(-0.035~-0.026) 0.002 -0.151 -12.230 < 0.001 T2DM -0.012(-0.020~-0.004) 0.004 -0.038 -2.897 0.004 吸烟史 -0.004(-0.007~-0.001) 0.002 -0.032 -2.582 0.010 锻炼情况 -0.003(-0.005~-0.001) 0.001 -0.035 -3.306 0.001 体力劳动 0.008(0.004~0.013) 0.002 0.038 3.573 < 0.001 SBP(mm Hg) -0.001(-0.001~0.000) 0.000 -0.138 -8.313 < 0.001 DBP(mm Hg) 0.000(0.000~0.001) 0.000 0.076 4.929 < 0.001 TG(mmol/L) 0.004(0.002~0.005) 0.001 0.055 4.887 < 0.001 TC(mmol/L) -0.007(-0.008~-0.005) 0.001 -0.103 -9.444 < 0.001
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