论著

基于NHANES数据库中年人群血清同型半胱氨酸水平与肾功能下降的阈值效应分析

Threshold effect of serum homocysteine level on kidney function decline among middle-aged adults in America based on NHANES database

:1061-1068
 
目的 血清同型半胱氨酸(Hcy)水平与慢性肾脏病(CKD)的进展相关,但中年人群的非线性关联研究较少,本研究旨在寻找慢性肾脏病危险因素。方法 本研究基于NHANES 1996—2006年数据,纳入5 361例45~65岁参与者,以估算肾小球滤过率(eGFR)<60 mL/(min·1.73 m2)和尿白蛋白/肌酐比值(uACR)≥30 mg/g评估肾功能下降。结果 通过逻辑回归及平滑曲线拟合分析发现,Hcy每升高1 µmol/L,eGFR降低的风险增加8%(OR=1.08,95%CI:1.06~1.10),uACR升高的风险增加2%(OR=1.02,95%CI:1.00~1.04)。非线性分析显示,Hcy对eGFR的阈值效应拐点为13.4 µmol/L(拐点左侧OR=1.59,95%CI:1.49~1.70;右侧无显著关联)。亚组分析表明,性别、高血压、糖尿病等协变量无交互作用,然而,在敏感性分析中,糖尿病患者中Hcy与eGFR降低的关联更强(交互P=0.015 8)。结论 本研究提示,控制Hcy水平或可延缓美国中年人群(尤其是糖尿病患者)的肾功能衰退。
Objective Elevated serum homocysteine(Hcy)levels are linked to chronic kidney disease(CKD)progression,yet the nonlinear relationship in middle-aged populations remains underexplored.Methods This study analyzed data from 5 361 participants aged 45-65 years in the NHANES 1996-2006 cohort.Renal dysfunction was defined as an estimated glomerular filtration rate(eGFR)<60 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio(uACR)≥30 mg/g.Results Logistic regression and smoothed curve fitting revealed that each 1 µmol/L increase in Hcy elevated the risk of reduced eGFR by 8%(OR=1.08,95% CI:1.06-1.10)and uACR by 2%(OR=1.02,95% CI:1.00-1.04).A nonlinear threshold effect was identified at 13.4 µmol/L,with a stronger association below this threshold(OR=1.59,95% CI:1.49-1.70)and no significant effect above it.Subgroup analyses showed no interactions with gender or hypertension,but a stronger Hcy-eGFR association was observed in diabetics(interaction P=0.0158).Conclusions These findings suggest that controlling Hcy levels may mitigate renal decline,particularly in diabetic populations,warranting further causal investigations.
论著

复方丹参注射液对轻度子痫前期患者肾功能及妊娠结局的影响

Effect of compound Danshen injection on kidney function and outcomes of pregnancy in mild preeclampsia patients

:10-12
 
目的 分析复方丹参注射液对轻度子痫前期患者肾功能与妊娠结局的影响。方法 对照组:在1000 mL浓度为5%的葡萄糖注射液中加入60 mL浓度为25%的硫酸镁,每天静滴1次,以连续静滴5 d为一个疗程;观察组:在250 ml浓度为5%的葡萄糖注射液中加入20 mL复方丹参注射液行静脉滴注治疗,每天静滴1次,以连续静滴5 d为一个疗程。结果 观察组的总有效率为96.88%,对照组为78.13%,观察组高于对照组,两组存在差异(P<0.05)。结论 为了有效改善轻度子痫前期患者的妊娠结局及预后,建议在临床中推广使用复方丹参注射液。
Objective The Objective of the investigation was to study how compound danshen injection(CDI)affected the kidney function and pregnant outcomes of patients diagnosed as mild preeclampsia. Methods Samples are randomly divided into two groups:observation group,in which patients were treated with magnesium sulfate,and control group,in which patients were treated with Danshen injection. Results In control group the treatment showed valid effect in 78.13% of the patients,and in observation group the ratio was 96.88%, which was remarkably higher. Conclusion To improve the pregnant outcomes and prognosis of mild preeclampsia,compound danshen injection should be recommended during the clinical practice.
论著

基于 NHANES 数据库中年人群血清同型半胱氨酸水平与肾功能下降的阈值效应分析

Threshold effect of serum homocysteine level on kidney function decline among middle-aged adults in America based on NHANES database

:1061-1068
 
       目的   血清同型半胱氨酸(Hcy)水平与慢性肾脏病(CKD)的进展相关,但中年人群的非线性关联研究较少,本研究旨在寻找慢性肾脏病危险因素。方法   本研究基于NHANES 1996—2006年数据,纳入5 361例45~65岁参与者,以估算肾小球滤过率(eGFR)<60 mL/(min·1.73 m2 )和尿白蛋白/肌酐比值(uACR)≥30 mg/g评估肾功能下降。结果   通过逻辑回归及平滑曲线拟合分析发现,Hcy每升高1 µmol/L,eGFR降低的风险增加8%(OR=1.08,95%CI1.06~1.10),uACR升高的风险增加2%(OR=1.02,95%CI:1.00~1.04)。非线性分析显示,Hcy对eGFR的阈值效应拐点为13.4 µmol/L(拐点左侧OR=1.59,95%CI:1.49~1.70;右侧无显著关联)。亚组分析表明,性别、高血压、糖尿病等协变量无交互作用,然而,在敏感性分析中,糖尿病患者中Hcy与eGFR降低的关联更强(交互P=0.015 8)。结论   本研究提示,控制Hcy水平或可延缓美国中年人群(尤其是糖尿病患者)的肾功能衰退。
        Objective   Elevated serum homocysteine(Hcy)levels are linked to chronic kidney disease(CKD)progression,yet the nonlinear relationship in middle-aged populations remains underexplored.Methods  This  study analyzed data from 5 361 participants aged 45–65 years in the NHANES 1996–2006 cohort.Renal dysfunction was defined as an estimated glomerular filtration rate(eGFR)<60 mL/min/1.73 m2  and urinary albumin-to-creatinine ratio(uACR)≥30 mg/g.Results  Logistic regression and smoothed curve fitting revealed that each 1 µmol/L increase in Hcy elevated the risk of reduced eGFR by 8%(OR=1.08,95% CI:1.06–1.10)and uACR by 2%(OR=1.02,95% CI:1.00–1.04).A nonlinear threshold effect was identified at 13.4 µmol/L,with a stronger association below this threshold(OR=1.59,95% CI:1.49–1.70)and no significant effect above it.Subgroup analyses showed no interactions with gender or hypertension,but a stronger Hcy-eGFR association was observed in diabetics(interaction P=0.0158).Conclusions  These findings suggest that controlling Hcy levels may mitigate renal decline,particularly in diabetic populations,warranting further causal investigations.
出版者信息








《广州医药》公众号