肱踝脉搏波传导速度与中青年人群慢性肾病发病风险的关系

The relationship between brachial-ankle pulse wave velocity and risk of chronic kidney disease in young and middle-aged people

摘要:

目的]探讨肱踝脉搏波传导速度(BaPWV)与中青年人群慢性肾病(CKD)发病风险的关联性。 [方法]应用前瞻性队列研究,选取2010年首次参加BaPWV调查的开滦集团职工健康查体中青年人群(n＝5 835)为研究对象。以体检BaPWV水平按四分位数将研究对象分为四组。每两年随访1次,以新发CKD、死亡或至随访结束(2020年12月31日)为随访终点。分析BaPWV与中青年人群CKD发病风险是否具有关联性。 [结果](1)研究人群中男性4 029例(69.05%),女性1 806例(30.95%),年龄为(48.09±6.30)岁。(2)随访中903例患者新发CKD,中位随访时间9.47(5.16,10.18)年。Q1组患者发生CKD 159例(10.91%),发病密度11.56(9.89,13.50)/千人年；Q2组患者发生CKD 195例(13.36%),发病密度14.31(12.43,16.46)/千人年；Q3组患者发生CKD 248例(17.00%),发病密度18.50(16.33,20.95)/千人年；Q4组患者发生CKD 301例(20.63%),发病密度23.41(20.91,26.21)/千人年。随着BaPWV水平升高,四组患者新发CKD累积发病率逐渐升高,且均有统计学意义(P＜0.001)；(3)多因素Cox回归结果显示,与Q1组相比,Q2组、Q3组和Q4组发生CKD的HR(95%CI)分别为1.08(0.87～1.34)、1.27(1.03～1.58)和1.44(1.14～1.82)(P趋势＜0.001)。 [结论]BaPWV与中青年人群CKD发病风险具有明显关联性。

Abstract:

Aim To investigate the relationship between brachial-ankle pulse wave velocity (BaPWV) and the risk of chronic kidney disease (CKD) in young and middle-aged people. Methods Using a prospective cohort study design, the young and middle-aged population (n＝5 835) of Kailuan Group workers who participated in the BaPWV survey for the first time during their health check-up in 2010 were selected for the study. The participants were divided into four groups according to the quartiles of BaPWV level. Follow-up was performed every two years, with new-onset CKD, death or the end of follow-up (31 December 2020) as the follow-up endpoints. The association between BaPWV and the risk incident CKD in young and middle-aged people was analyzed. Results (1) The study population consisted of 4 029 (69.05%) males and 1 806 (30.95%) females aged (48.09±6.30) years. (2) New-onset CKD occurred in 903 patients during follow-up, with a median follow-up time of 9.47 (5.6,0.18) years. 159 (10.91%) patients in the group Q1 had CKD, with an incidence density of 11.56 (9.9,3.50)/1 000 person-years; 195 (13.36%) patients in the group Q2 had CKD, with an incidence density of 14.31 (12.3,6.46)/1 000 person-years; 248 (17.00%) patients in group Q3 developed CKD with an incidence density of 18.50 (16.3,0.95)/1 000 person-years; 301 (20.63%) patients in group Q4 developed CKD with an incidence density of 23.41 (20.1,6.21)/1 000 person-years.The cumulative incidence of new-onset CKD in patients in the four groups gradually increased with increasing BaPWV levels, and all of them were statistically significant (P＜0.001). (3) The results of multifactorial Cox regression showed that compared with group Q1, the HR (95%CI) for the incidence of CKD in group Q2, Q3, Q4 were 1.08 (0.87～1.34), 1.27 (1.03～1.58), 1.44 (1.14～1.82)(P_trend＜0.001). Conclusion BaPWV is significantly associated with the risk of CKD in young and middle-aged people.