摘要
背景微量白蛋白尿是反应肾脏早期微血管损害的敏感指标,也是心血管疾病的独立危险因素,既往研究表明长期慢性炎症在微量白蛋白尿的发生、发展中起着重要作用,但血液炎症标志物与微量白蛋白尿相关性的报道较少。目的探讨中老年体检人群中系统免疫炎症指数(SII)和系统炎症反应指数(SIRI)与微量白蛋白尿的相关性。方法本研究为横断面研究,选取2023年4—7月于东部战区总医院健康医学科进行健康体检的2105例40岁以上体检者为研究对象。根据尿微量白蛋白/尿肌酐比值(UACR)将研究对象分为两组:非微量白蛋白尿组(1857例,UACR<30 mg/g)和微量白蛋白尿组(248例,UACR=30~300 mg/g)。根据三分位数将SII分为T1(0.09~0.27)、T2(0.28~0.40)和T3(0.41~1.38),将SIRI分为t1(0.11~0.41)、t2(0.42~0.66)和t3(0.67~3.52)。收集两组研究对象的一般资料及实验室检查结果并进行比较,采用线性回归分析探讨SII、SIRI水平与UACR对数转化值(log UACR)的相关性,采用二元Logistic回归分析探讨SII、SIRI与微量白蛋白尿发生风险的相关性。结果两组性别、腰臀比、总胆固醇、低密度脂蛋白胆固醇、尿酸水平比较,差异无统计学意义(P>0.05);微量白蛋白尿组年龄、BMI、收缩压、舒张压、空腹血糖、餐后2 h血糖、糖化血红蛋白、三酰甘油、同型半胱氨酸、肾小球滤过率、红细胞沉降率、SII、SIRI水平高于非微量白蛋白尿组,高密度脂蛋白胆固醇水平低于非微量白蛋白尿组(P<0.05)。线性回归分析结果显示,SII、SIRI水平与log UACR均呈正相关(P<0.05)。二元Logistic回归分析结果显示,校正各控制变量后,SII水平升高是微量白蛋白尿发生风险的危险因素(OR=1.17,95%CI=1.01~1.35,P=0.031);与T1水平患者相比,T3水平患者微量白蛋白尿发生风险升高(OR=1.43,95%CI=1.01~2.03,P=0.046),且微量白蛋白尿发生风险随着SII增加呈升高趋势(P趋势=0.038)。校正各控制变量后,SIRI水平升高是微量白蛋白尿发生风险的危险因素(OR=1.18,95%CI=1.03~1.35,P=0.019);与t1水平患者相比,t3水平患者微量白蛋白尿发生风险升高(OR=1.45,95%CI=1.01~2.09,P=0.046),且微量白蛋白尿发生风险随着SIRI增加呈升高趋势(P趋势=0.032)。结论中老年体检人群SII、SIRI水平与log UACR及微量白蛋白尿发生风险均呈正相关。
Background Microalbuminuria is a sensitive indicator of early renal microvascular damage and an independent risk factor for cardiovascular diseases.Previous studies have shown that long-term chronic inflammation plays an important role in the occurrence and development of microalbuminuria.However,the correlation between blood inflammatory markers and microalbuminuria has been less frequently reported.Objective To investigate the correlation of systemic immune inflammatory index(SII)and systemic inflammatory response index(SIRI)with microalbuminuria in a middle-aged and elderly physical examination population.Methods This was a cross-sectional study in which 2105 medical examiners over the age of 40 years who underwent health check-ups from April to July 2023 at the Department of Health Medicine,General Hospital of the Eastern Theatre of Operations were selected as study subjects.The study subjects were divided into two groups based on the urinary microalbumin/urinary creatinine ratio(UACR)values:the non-microalbuminuric group(1857 cases,UACR<30 mg/g)and the microalbuminuric group(248 cases,UACR=30-300 mg/g).SII was divided into T1(0.09-0.27),T2(0.28-0.40)and T3(0.41-1.38)according to tertile grouping,and SIRI was divided into t1(0.11-0.41),t2(0.42-0.66)and t3(0.67-3.52).The general information and laboratory test results of the two study groups were collected and compared,and linear regression analysis was used to explore the correlation between the levels of SII and SIRI and the log-transformed value of UACR(log UACR),and binary Logistic regression analysis was used to explore the correlation between the levels of SII and SIRI and the risk of microalbuminuria.Results Comparison of gender,waist-to-hip ratio,total cholesterol,low density lipoprotein cholesterol,and uric acid levels between the two groups showed no statistically significant difference(P>0.05);age,BMI,systolic blood pressure,diastolic blood pressure,fasting blood glucose,2 h blood glucose,glycosylated hemoglobin,triglycerides,homocysteine,glomerular filtration rate erythrocyte sedimentation rate,SII,and SIRI levels were higher in the microalbuminuria group than those in the non-microalbuminuria group,and high density lipoprotein cholesterol level was lower than that in the non-microalbuminuria group(P<0.05).Linear regression analysis showed that the levels of SII and SIRI were positively correlated with log UACR(P<0.05).The results of binary Logistic regression analysis showed that,after correcting for each control variable,elevated SII levels was a risk factor for microalbuminuria(OR=1.17,95%CI=1.01-1.35,P=0.031),and T3 was positively correlated with the risk of microalbuminuria when compared to T1(OR=1.43,95%CI=1.01-2.03,P=0.046),and the risk of microalbuminuria tended to increase with increasing SII(Ptrend=0.038).After correcting for each control variable,elevated SIRI levels was a risk factor for microalbuminuria(OR=1.18,95%CI=1.03-1.35,P=0.019);t3 was positively correlated with the risk of microalbuminuria compared to t1(OR=1.45,95%CI=1.01-2.09,P=0.046)and the risk tended to increase with increasing SIRI(Ptrend=0.032).Conclusion SII and SIRI levels correlated positively with both log UACR and risk of microalbuminuria in middle-aged and elderly subjects who received health examination.
作者
黄亚
倪文吉
张锐
李丹丹
周颖
金涛
钟勇
HUANG Ya;NI Wenji;ZHANG Rui;LI Dandan;ZHOU Ying;JIN Tao;ZHONG Yong(Health Medicine Department,Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University(General Hospital of Eastern Theater Command),Nanjing 210018,China)
出处
《中国全科医学》
CAS
北大核心
2024年第18期2186-2191,共6页
Chinese General Practice
基金
江苏省老年健康科研项目(LKM2023021)。
关键词
白蛋白尿
微量白蛋白尿
系统免疫炎症指数
系统炎症反应指数
中老年
Albuminuria
Microalbuminuria
Systemic immune inflammatory index
Systemic inflammatory response index
Middle-aged and elderly
