肌酐清除率与单纯性肾囊肿相关性的巢式病例对照研究

马执彬; 权佩钦; 杨超; 钭丰; 杜红梅; 李建建; 赵怡妮; 白亚娜; 任晓卫; 胡晓斌

doi:10.16462/j.cnki.zhjbkz.2022.11.013

肌酐清除率与单纯性肾囊肿相关性的巢式病例对照研究

doi: 10.16462/j.cnki.zhjbkz.2022.11.013

730000 兰州, 兰州大学公共卫生学院流行病与卫生统计学研究所

基金项目:

甘肃省自然科学基金 20JR10RA599

详细信息

通讯作者:
胡晓斌, E-mail: huxiaobin@lzu.edu.cn

中图分类号: R181.1
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-27
- 修回日期: 2022-03-23
- 网络出版日期: 2022-12-21
- 刊出日期: 2022-11-10

Relationship between creatinine clearance rate and simple renal cysts: a nested case-control study

Department of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China

Funds:

Natural Science Foundation of Gansu Province 20JR10RA599

More Information

Corresponding author: HU Xiao-bin, E-mail: huxiaobin@lzu.edu.cn

摘要

摘要: 目的探讨金昌队列人群基线肌酐清除率(creatinine clearance rate, Ccr)与随访单纯性肾囊肿(simple renal cysts, SRCs)之间的相关性，为SRCs的防治提供科学依据。方法基于金昌队列，采用巢式病例对照研究方法，研究对象包括859名SRCs病例和859名按照随访时间、年龄、性别、高血压匹配的对照。分别使用单因素和多因素条件logistic回归分析模型分析基线Ccr与随访SRCs之间的关联，计算OR和95%CI值。然后应用限制性立方样条分析基线Ccr与随访SRCs之间的剂量-反应关系。结果调整混杂因素后多因素条件logistic回归分析模型结果显示，基线Ccr < 60.00 mL·min^-1·1.73m^-2、60.00~ < 70.00 mL·min^-1·1.73m^-2者发生SRCs的风险分别是Ccr≥80.00 mL·min^-1·1.73m^-2者的2.10倍(95% CI: 1.13~3.89)、1.57倍(95% CI: 1.03~2.39)。限制性立方样条结果显示，金昌队列人群基线Ccr与随访SRCs之间存在反向非线性剂量-反应关系。结论低Ccr是SRCs的独立危险因素，当基线Ccr < 80.00 mL·min^-1·1.73m^-2时，金昌队列人群SRCs的发病风险随Ccr降低而增加。
- 肌酐清除率 /
- 单纯性肾囊肿 /
- 巢式病例对照研究
Abstract: Objective To explore the correlation between baseline creatinine clearance rate (Ccr) and follow-up of simple renal cysts (SRCs) in Jinchang cohort population, and to provide a scientific basis for the prevention and treatment of SRCs. Methods Based on the Jinchang cohort, nested case control method was used in this study, the subjects included 859 cases of SRCs and 859 controls matched according to follow-up time, age, gender and hypertension. The association between baseline Ccr and follow-up of SRCs was analyzed by univariate and multivariate conditional logistic regression models respectively, and the OR with 95% CI values were calculated. Then the dose-response relationship between baseline Ccr and follow-up of SRCs was analyzed by using restrictive cubic spline. Results After adjusting for confounding variables, compared to the interval with baseline Ccr higher than 80.00 mL·min^-1·1.73m^-2, the result of multivariate conditional logistic regression showed that the risk of SRCs in the interval with baseline Ccr lower than 60.00 mL·min^-1·1.73m^-2 and interval with baseline Ccr between 60.00- < 70.00 mL·min^-1·1.73m^-2 was 2.10 times [95% CI: 1.13-3.89)], and 1.57 times [95% CI: 1.03-2.39)], respectively. The results of restricted cubic spline showed that there was an inverse nonlinear dose-response relationship between baseline Ccr and follow-up of SRCs in the Jinchang cohort population. Conclusions Low creatinine clearance is an independent risk factor for SRCs, and when the baseline Ccr was lower than 80.00 mL·min^-1·1.73m^-2, the risk of SRCs in the Jinchang cohort population increased with the decrease of Ccr.
- Creatinine clearance rate /
- Simple renal cysts /
- Nested case control study

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图 1 金昌队列人群基线Ccr与随访SRCs之间的剂量-反应关系

Figure 1. Dose-response relationship between baseline Ccr and follow-up of SRCs in Jinchang cohort population

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表 1 金昌队列人群859名SRCs病例与859名对照基线特征比较[n(%)]

Table 1. Comparison of baseline characteristics of 859 SRCs cases and 859 controls in Jinchang cohort population [n(%)]

变量	病例组(n=859)	对照组(n=859)	χ²/Z值	P值
文化程度			14.347 ^a	0.158
小学及以下	212(24.68)	208(24.21)
初中	287(33.41)	247(28.76)
高中/中专/技校	207(24.10)	221(25.73)
大专	92(10.71)	108(12.57)
本科及以上	61(7.10)	75(8.73)
职业			35.688 ^a	< 0.001
干部	117(13.62)	116(13.50)
工人	625(72.76)	684(79.63)
技术人员	34(3.96)	32(3.73)
内勤服务人员	83(9.66)	27(3.14)
吸烟			6.683 ^a	0.083
从不	394(45.87)	391(45.52)
目前吸	314(36.55)	320(37.25)
已戒	151(17.58)	148(17.23)
循环系统疾病			9.852 ^b	0.002
否	550(64.03)	602(70.08)
是	309(35.97)	257(29.92)
糖尿病			1.787 ^b	0.181
否	729(84.87)	749(87.19)
是	130(15.13)	110(12.81)
BMI[M(P₂₅, P₇₅), kg/m²]	24.34(22.31, 26.51)	24.28(22.22, 26.30)	-0.961 ^c	0.360
SBP[M(P₂₅, P₇₅), mm Hg]	129.00(116.00, 143.00)	129.00(116.00, 145.00)	-0.921 ^c	0.357
DBP[M(P₂₅, P₇₅), mm Hg]	81.00(72.00, 90.00)	81.00(73.00, 91.00)	-0.337 ^c	0.736
FPG[M(P₂₅, P₇₅), mm Hg]	5.30(4.90, 5.90)	5.30(4.90, 5.90)	-1.478 ^c	0.139
Scr[M(P₂₅, P₇₅), μmol/L]	72.00(63.00, 82.00)	70.00(62.00, 79.00)	-2.340 ^c	0.019
BUN[M(P₂₅, P₇₅), mmol/L]	5.50(4.70, 6.50)	5.50(4.60, 6.40)	-0.991 ^c	0.322
UA[M(P₂₅, P₇₅), μmol/L]	338.00(278.00, 395.50)	334.00(282.50, 393.50)	-0.501 ^c	0.616
Ccr[M(P₂₅, P₇₅), mL·min^-1·1.73m^-2]	93.00(75.00, 111.00)	95.00(79.00, 111.00)	-3.304 ^c	0.001
TC[M(P₂₅, P₇₅), mmol/L]	4.60(4.00, 5.30)	4.80(4.20, 5.40)	-3.081 ^c	0.002
TG[M(P₂₅, P₇₅), mmol/L]	1.60(1.10, 2.30)	1.80(1.30, 2.50)	-3.302 ^c	0.001
HDL-C[M(P₂₅, P₇₅), mmol/L]	1.27(1.07, 1.52)	1.27(1.06, 1.49)	-0.331 ^c	0.741
LDL-C[M(P₂₅, P₇₅), mmol/L]	3.06(2.58, 3.57)	3.21(2.75, 3.74)	-4.558 ^c	< 0.001
注：^aBowker检验；^bMcNemar检验；^cWilcoxon符号秩和检验。

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表 2 金昌队列人群基线Ccr与随访SRCs之间的相关性

Table 2. Correlation between baseline Ccr and follow-up of SRCs in Jinchang cohort population

Ccr (mL·min^-1·1.73m^-2)	病例/对照	单因素模型OR (95% CI值	多因素模型
Ccr (mL·min^-1·1.73m^-2)	病例/对照	单因素模型OR (95% CI值	模型1 OR (95% CI)值	模型2 OR (95% CI)值
< 60.00	67/40	2.42 (1.47~4.00)	2.27 (1.36~3.80)	2.10 (1.13~3.89)
60.00~ < 70.00	92/71	1.63 (1.12~2.36)	1.65 (1.13~2.42)	1.57 (1.03~2.39)
70.00~ < 80.00	96/106	1.10 (0.80~1.51)	1.11 (0.80~1.55)	1.09 (0.77~1.55)
≥80.00	604/642	1.00	1.00	1.00
注：模型1：调整职业(干部、工人、技术人员、内勤服务人员)、吸烟(从不、目前吸、已戒)、循环系统疾病(否/是)；模型2：在模型1的基础上进一步调整Scr、TC、TG、LDL-C。

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