摘要
目的以人群为基础探讨脂质异常与肾结石发生的关系。方法所有参与者均接受问卷调查、体格检查及肝肾功能、血脂、血糖、糖化血红蛋白等实验室检测，肾结石以双肾B超检查诊断。估算肾小球滤过率（eGFR）〈60ml·min^-1·（1．73m2）。者排除在外。结果共纳入10316例参与者，平均年龄（54．88＋10．27）岁（17～88岁），男女比例为1：1．12，肾结石的总患病率为5．6％，男、女性肾结石患病率分别为7．8％和3．7％（P〈0．01）。在女性，仅有eGFR在结石组明显低于非结石组（P〈0．05）。在男性，与非结石组相比，结石组参与者年龄更大（P〈0．05），血压和血尿酸更高（均P〈0．01），肾功能更差（血肌酐，P〈0．05；eGFR，P〈0．01），低密度脂蛋白（LDL）更高（P〈0．05）。Logistic回归分析显示，在女性，仅有eGFR（P〈0．05）为肾结石的独立影响因素；在男性，除平均动脉压和eGFR外，LDL亦为肾结石的独立影响因素，危险比为1．149（95％CI1．003～1．317，P〈0．05）。进一步将LDL分为正常组、边缘升高组和高LDL组，随着LDL的升高，男性结石的患病率明显增加，3组结石患病率分别为7．3％、83％和10．6％。而总胆固醇、三酰甘油和高密度脂蛋白与肾结石无明显相关。结论脂质异常与男性肾结石相关，高LDL为男性肾结石的独立危险因素。临床血脂检测不仅有助于减少动粥样硬化性疾病，也可降低肾结石风险。
Objective To investigate the relationship between dyslipidemia and nephrolithiasis in a population- based study. Methods All participants were investigated by questionnaires, physical examinations and laboratory tests including liver and renal function, lipid profile, serum fasting glucose, glycosylated hemoglobin. Nephrolithiasis was diagnosed by kidney B- ultrasonography. Subjects with estimated glomerular filtration rate （eGFR） 〈 60 ml · min^-1 （1.73 m2）-1 were excluded. Results 10 316 individuals were enrolled with an average age of （54.88 ± 10.27） years （range 17-88 years） and the ratio of male to female 1 ： 1.12. The prevalence of nephrolithiasis was 5.6%, 3.7% and 7.8% for whole population, women and men, respectively. In women, only eGFR in stone group was significantly lower than that in non-stone group （P 〈 0.05）. However, participants in stone group were significantly older （P 〈 0.05）, of higher blood pressure （P 〈 0.01）, higher serum uric acid （P 〈 0.01）, worse renal function （serum creatinine, P 〈 0.05; eGFR, P 〈 0.01）, and higher lowdensity lipoprotein （LDL） （P 〈 0.05）, compared with those in non- stone group in men. Logistic regression analysis showed that only eGFR （P 〈 0.05） was the independent influential factor for kidney stones in women; In men, LDL was an independent influential factor for nephrolithiasis with a hazard ratio of 1.149 （95%CI 1.003- 1.317, P 〈 0.05）, except for mean blood pressure and eGFR. After being divided into normal group, borderline high group and high LDL group according to the LDL level, with the increase of LDL, the prevalence of nephrolithiasis was significantly increased by 7.3%, 8.3% and 10.6% in men respectively. There was no significant relationship between total cholesterol, triglyceride, high- density lipoprotein and nephrolithiasis. Conclusions Dyslipidemia is associated with nephrolithiasis in men, and high LDL cholesterol is an independent risk factor for nephrolithiasis. Clinical lipid testing not only helps to reduce the risk of atherosclerotic disease, but also reduces the risk of kidney stones.
出处
《中华肾脏病杂志》
CSCD
北大核心
2017年第7期517-523,共7页
Chinese Journal of Nephrology
基金
国家十二五科技支撑计划（2012BAJ18803）
