Relationships of arterial hypertension and reduced renal function in a population 25–45 years
Взаимосвязи артериальной гипертензии и сниженной функции почек в популяции 25–45 лет

N.A. Kovalkova, Yu.I. Ragino, L.V. Scherbakova, A.D. Hudyakovа, D.V. Denisova, M.I. Voevoda
2019 Терапевтический архив  
Взаимосвязи артериальной гипертензии и сниженной функции почек в популяции 25-45 лет Í.À. Êîâàëüêîâà, Þ.È. Ðàãèíî, Ë.Â. Ùåðáàêîâà, À.Ä. Õóäÿêîâà, Ä.Â. Äåíèñîâà, Ì.È. Âîåâîäà Íàó÷íî-èññëåäîâàòåëüñêèé èíñòèòóò òåðàïèè è ïðîôèëàêòè÷åñêîé ìåäèöèíû -ôèëèàë ÔÃÁÍÓ «Ôåäåðàëüíûé èññëåäîâàòåëüñêèé öåíòð Èíñòèòóò öèòîëîãèè è ãåíåòèêè Ñèáèðñêîãî îòäåëåíèÿ Ðîññèéñêîé àêàäåìèè íàóê» (ÍÈÈÒÏÌ -ôèëèàë ÈÖèà ÑÎ ÐÀÍ), ëàáîðàòîðèÿ êëèíè÷åñêèõ áèîõèìè÷åñêèõ è ãîðìîíàëüíûõ èññëåäîâàíèé òåðàïåâòè÷åñêèõ çàáîëåâàíèé,
more » ... êèõ çàáîëåâàíèé, Íîâîñèáèðñê, Ðîññèÿ Ðåçþìå Öåëü. Èçó÷èòü âçàèìîñâÿçè ñíèaeåííîé ôóíêöèè ïî÷åê ñ àðòåðèàëüíîé ãèïåðòåíçèåé (ÀÃ) è äðóãèìè êàðäèîìåòàáîëè÷åñêèìè ôàêòîðàìè ðèñêà â ïîïóëÿöèè 25-45 ëåò. Ìàòåðèàëû è ìåòîäû. òå÷åíèå 2013-2016 ãã. ïðîâåäåíî îäíîìîìåíòíîå ïîïóëÿöèîííîå îáñëåäîâàíèå íàñåëåíèÿ ã. Íîâîñèáèðñêà 25-45 ëåò. Âñåãî îáñëåäîâàíî 1074 ÷åëîâåêà (468 ìóae÷èí è 606 aeåíùèí). Ðåñïîíäåíòàì èçìåðÿëè àðòåðèàëüíîå äàâëåíèå (ÀÄ), îêðóaeíîñòü òàëèè (ÎÒ), â êðîâè èññëåäîâàëè óðîâíè ëèïèäîâ, ãëþêîçû, êðåàòèíèíà. Ðàñ÷åò ñêîðîñòè êëóáî÷êîâîé ôèëüòðàöèè (ÑÊÔ) ïðîâîäèëñÿ ïî ôîðìóëå CKD-EPI. Àà ðåãèñòðèðîâàëè ïðè ÀÄ≥140/90 ìì ðò. ñò., ñíèaeåííóþ ôóíêöèþ ïî÷åêïðè ÑÊÔ <90 ìë/ìèí/1,73 ñì 2 . Ðåçóëüòàòû. Ðàñïðîñòðàíåííîñòü Àà ñîñòàâèëà ñðåäè ìóae÷èí 28%, ñðåäè aeåíùèí -9%. Äîëÿ ëèö ñ ÑÊÔ <90 ìë/ìèí/1,73 ñì 2 ñðåäè ìóae÷èí ñîñòàâèëà 9,8%, ñðåäè aeåíùèí -34%. Ïðè ýòîì ñðåäè âñåõ îáñëåäîâàííûõ ÑÊÔ <60 ìë/ìèí/1,73 ñì 2 ðåãèñòðèðîâàëàñü ëèøü â 0,3% ñëó÷àåâ. Ñâÿçü Àà ñî ñíèaeåííîé ôóíêöèåé ïî÷åê îïðåäåëÿëàñü òîëüêî ó ìóae÷èí. Ïî ðåçóëüòàòàì ìíîãîôàêòîðíîãî ëèíåéíîãî ðåãðåññèîííîãî àíàëèçà îïðåäåëÿëàñü äîñòîâåðíàÿ îòðèöàòåëüíàÿ ñâÿçü ÑÊÔ ñ âîçðàñòîì, íå âûÿâëåíî àññîöèàöèé ÑÊÔ ñ ñèñòîëè÷åñêèì ÀÄ íè ó ìóae÷èí, íè ó aeåíùèí. Ó ìóae÷èí îïðåäåëÿëàñü îáðàòíàÿ ñâÿçü ÑÊÔ ñ õîëåñòåðèíîì (ÕÑ) ëèïîïðîòåèíîâ íèçêîé ïëîòíîñòè (ËÏÍÏ), òðèãëèöåðèäàìè (ÒÃ), ïðÿìàÿ -ñ ÎÒ. Äîñòîâåðíàÿ îáðàòíàÿ àññîöèàöèÿ ÑÊÔ ñ äèàñòîëè÷åñêèì ÀÄ (ÄÀÄ) äîñòèãàëàñü ëèøü ïðè èñêëþ÷åíèè èç ðåãðåññèîííîé ìîäåëè ÒÃ. Ó aeåíùèí îïðåäåëÿëàñü îáðàòíàÿ ñâÿçü ÑÊÔ ñ ÕÑ ËÏÍÏ, ÄÀÄ, ïðÿìàÿ -ñ ÎÒ. Ïðè ïîøàãîâîì àíàëèçå ïîäòâåðaeäåíà äîñòîâåðíîñòü âñåõ äîñòèãíóòûõ àññîöèàöèé çà èñêëþ÷åíèåì ñâÿçè ÑÊÔ ñ ÎÒ ó ìóae÷èí. Çàêëþ÷åíèå. ïîïóëÿöèè 25-45 ëåò ñíèaeåíèå ÑÊÔ àññîöèèðîâàëîñü ñ ïîâûøåíèåì ÄÀÄ; óðîâíè ÕÑ ËÏÍÏ, Òà îáðàòíî àññîöèèðîâàëèñü ñ óðîâíåì ÑÊÔ; ó ìóae÷èí 25-45 ëåò ïîâûøåíèå óðîâíÿ Òà èìåëî áîëüøåå çíà÷åíèå â ñíèaeåíèè ÑÊÔ, ÷åì ïîâûøåíèå ÄÀÄ. Êëþ÷åâûå ñëîâà: ýïèäåìèîëîãè÷åñêîå èññëåäîâàíèå, àðòåðèàëüíàÿ ãèïåðòåíçèÿ, ñêîðîñòü êëóáî÷êîâîé ôèëüòðàöèè, ôóíêöèÿ ïî-÷åê, êàðäèîìåòàáîëè÷åñêèå ôàêòîðû ðèñêà. Äëÿ öèòèðîâàíèÿ: Êîâàëüêîâà Í.À., Ðàãèíî Þ.È., Ùåðáàêîâà Ë.Â. è äð. Âçàèìîñâÿçè àðòåðèàëüíîé ãèïåðòåíçèè è ñíèaeåííîé ôóíêöèè ïî÷åê â ïîïóëÿöèè 25-45 ëåò. Òåðàïåâòè÷åñêèé àðõèâ. 2019; 91 (1): 64-70. Sciences (IIPM -Branch of IC&G SB RAS), laboratory of clinical biochemical and hormonal studies of therapeutic diseases, Novosibirsk, Russia Aim. To study relationships of reduced renal function with hypertension and other cardiometabolic risk factors in persons aged 25-45 years. Materials and methods. A cross-sectional population study of one of the typical district of Novosibirsk (Russia) was performed during 2013-2016 years. The study included 468 men and 606 women aged 25-45 years. Blood pressure (BP), waist circumference (WC), blood lipids, glucose, creatinine were measured. Glomerular filtration rate (GFR) was calculated with the formula CKD-EPI. Hypertension was registered if blood pressure (BP) was ≥140/90 mm Hg, reduced kidney function -at GFR<90 ml/min/1.73 cm 2 . Results. Prevalence of hypertension among men was 28%, among women -9%. The proportion of people with GFR<90 ml/min/1.73 cm 2 among men was 9.8%, among women -34%. Among all examined people GFRs <60 ml/min/1.73 cm 2 was revealed in 0.3% only. The association of hypertension with reduced renal function was determined only in men. Based on results of multivariate linear regression analysis, a significant negative association of GFR with age was determined, there was no association of GFR with systolic BP (SBP) in either men or women. In men, inverse relationships of GFR with low-density lipoprotein cholesterol (LDL-Ñ), triglycerides (TG), direct -with WC were determined. Significant inverse association of GFR with diastolic BP (DBP) was revealed only after exception of TG from the regression model. In women, GFR's inverse relationship with LDL-Ñ and DBP was observed, and the direct -with WC. In stepwise analysis the validity of all associations was confirmed after exception of the association of GFR with WC in men. Conclusions. In a population of 25-45 years a reduced GFR was associated with increased DBP; levels of LDL-Ñ, TG showed negative association with GFR; in men increased TG levels were more important in reducing GFR than elevated DBP. Keywords: epidemiological study, arterial hypertension, glomerular filtration rate, renal function, cardiometabolic risk factors. For citation: Kovalkova N.A., Ragino Yu.I., Scherbakova L.V. et al. Relationships of arterial hypertension and reduced renal function in a population 25-45 years. Therapeutic Archive. 2019; 91 (1): 64-70.
doi:10.26442/00403660.2019.01.000032 fatcat:65bdjl7lvbfj7iobsddbmacrmy