上海地区职业人群代谢综合征及其组分与早期肾损伤的相关性研究

目的 探讨上海地区职业人群代谢综合征（Metabolic Syndrome,MetS）和早期肾损伤的检出情况，分析MetS及其组分与早期肾损伤相关性。方法 选取2021年1—12月在华东疗养院进行健康体检的12251例上海地区职业人群为研究对象，以估算的肾小球滤过率(estimate glomerular filtration rate，eGFR)60≤eGFR＜90ml/( min·1.73m2)为依据诊断为早期肾损伤，MetS根据2017年版中华医学会糖尿病分会诊断标准进行诊断，研究该人群MetS及其不同组分中早期肾损伤的检出情况，并采用单因素与多因素logistic回归分析MetS及其组分与早期肾损伤的相关性。结果 该地区职业人群MetS和早期肾损伤的检出率分别为16.04%和24.86%，且eGFR值在MetS组与非MetS组间有统计学差异（t =2.967，P =0.003）；在MetS及其五个组分中，除高空腹血糖外，余阳性组的早期肾损伤检出率显著高于阴性组（P＜0.001），且随着组分数0~5的增高，早期肾损伤检出率逐渐增高（趋势x²=139.225， P＜0.001）；回归模型分析显示，性别（OR=2.407，95% CI:2.184～2.652）、年龄（OR=5.661，95% CI:4.622～6.934）、腹型肥胖(OR=1.177，95% CI: 1.072~1.292）、高血压( OR=1.319，95% CI: 1.208~1.441）、高TG血症(OR=1.403，95% CI: 1.286~1.531）、低HDL-C血症(OR=1.245，95% CI: 1.109~1.397）是早期肾损伤的危险因素；男性发生风险是女性的2.209倍（95%CI:1.983～2.460）；50岁以上人群是≤30岁人群的5.477倍（95%CI:4.448～6.745）； MetS的1～5项组分数发生早期肾损伤的风险分别为0.704（95%CI:0.597～0.830），1.124（95%CI:0.826～1.538），1.502（95%CI:1.143～1.843），1.697（95%CI:1.369～2.164），1.913（95%CI:1.234～2.251）。结论 上海地区职业人群早期肾损伤检出率较高，男性、年龄增长、腹型肥胖、高血压、高TG血症、低HDL-C血症是发生早期肾损伤的危险因素。

Correlation between early renal injury with the components and various combination metabolic syndromein of the occupational population in Shanghai

Objective To investigate the detection of Metabolic Syndrome (MetS) and early kidney injury in occupational population in Shanghai, and related influencing factors between MetS and early kidney injury. Methods A total of 12251 occupational groups in Shanghai who attended health check-ups at the East China Sanatorium from January 2021 to December 2021 were selected, the early kidney injury was diagnosed by estimated glomerular filtration rate (eGFR)60 ≤eGFR < 90ml(min·1.73m
2). MetS was diagnosed according to the diagnostic criteria of diabetes branch of Chinese medical association in 2017. The detection of early kidney injury in MetS and its different components in this population were studied. The pertinence between MetS and its components and early renal injury were analyzed by Logistic regression. Results The detection rates of MetS and early kidney injury were 16.04% and 24.86% respectively, and eGFR values were statistically different between MetS group and non-MetS group (t =2.967, P=0.003). The detection rate of MetS and its components and early renal injury were higher in males than females (P<0.001). Besides hyperfasting blood glucose, MetS and its five components, the detection rate of early kidney injury in positive group was statistically higher than that in negative group (P<0.001), by the increase of group score of 0-5, the detection rate of early kidney injury gradually increased (trend x²=139.225, P<0.001). And then the potential influencing factors of early renal injury were evaluated by logistic regression analysis, showing that: Gender(OR=2.407, 95%CI: 2.184-2.652), age(OR=5.661, 95%CI: 4.622-6.934), abdominal obesity(OR=1.177, 95%CI: 1.072-1.292), hypertension(OR=1.319, 95%CI: 1.208-1.441), hypertriglyceridemia(OR=1.403, 95%CI: 1.286-1.531) and low HDL-C(OR=1.245, 95%CI: 1.109-1.397) were risk factors for early kidney injury. The risk of male was 2.209 times(95%CI:1.983-2.460) higher than that of female, and the risk of 50 years was 5.477 times(95%CI:4.448-6.745) higher than that of ≤30 years. The risk of early kidney injury was 0.704 (95%CI: 0.597-0.830), 1.124 (95%CI: 0.826-1.538), 1.502(95%CI:1.143-1.843), 1.697(95%CI:1.369-2.164), 1.913(95%CI:1.234-2.251) according to MetS 1 to 5 scores. Conclusion The detection rate of early kidney injury is high in occupational population in Shanghai. Male, aging, abdominal obesity, hypertension, hypertriglyceridemia and low HDL-C are risk factors of early kidney injury.