Distribution Characteristics Of Estimated Glomerular Filtration Rate And Related Influential Factors Among Community Residents Over 40 With Differents Glucose Tolerance In Hefei City

Objective: To understand the characteristics of estimated glomerular filtration rate(eGFR)and its related factors in people over 40 years old in urban suburb of Hefei,so as to provide a theoretical basis for the early prevention and treatment of chronic kidney disease in hyperglycemia population.Methods: From April 2012 to December 2012,an epidemiological survey on the risk of tumor occurrence of type 2 diabetes in China was carried out in 4 communities over 40 years old and over from 4 communities in the suburb of Hefei.According to the standard of entry and discharge,8507 subjects were included in this study,of which5709 were normal(NGT),2095 patients with impaired glucose regulation(IGR),and703 patients with diabetes(DM).All subjects received questionnaires and physical examination,including age,sex,height,weight,systolic pressure,diastolic pressure,waist circumference,hip circumference,fatty liver,heart,cerebrovascular disease history,and so on.At the same time,related laboratory tests were given,including fasting blood glucose(FBG),1 hours postprandial blood glucose(1hPG),postprandial 2hour blood glucose(2hPG),serum triglyceride(TG),cholesterol(TCH),low density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol(HDL-c),and serum creatinine(Scr).Glutamic pyruvic transaminase(ALT),aspartate aminotransferase(AST),gamma glutaminyl transaminase(gamma-GT),glycosylated hemoglobin A1c(HbA1c)and so on.The eGFR was calculated by the formula of renal disease diet improvement test(MDRD).The characteristics of eGFR distribution inpeople with different glucose tolerance were analyzed,and Logistic regression analysis was used to understand the related factors of eGFR in people with abnormal glucose metabolism.Results:(1)Compared with group NGT,the age of group IGR and group DM,SBP,DBP,FBG,1hPG,2hPG,HbA1 c,Scr,TG,TCH,disease,coronary heart disease detection rate and fatty liver detection rate were all significantly increased(P< 0.05).Compared with the IGR group,the detection rates of SBP,DBP,1hPG,2hPG,HbA1 c,Scr,TG,TCH,LDL-C,ASL,fatty liver and fatty liver were all significantly higher in group DM(P< 0.05).In addition,the waist circumference of group IGR was significantly higher than that in group NGT(P < 0.05),but there was no significant difference in group DM(P< 0.05),and the proportion of male in group DM was significantly higher(P< 0.05),but there was no significant difference in IGR group(P>0.05).(2)In group NGT,the proportion of normal eGFR population was 64.8%,the proportion of mild descent population was 33.5%,and the proportion of moderate and severe declines was 1.7%.In group IGR,the proportion of normal people of eGFR was54.4%,the proportion of mild descent population was 43.2%,the proportion of moderate and severe declines was 2.4%,and in group DM,the proportion of normal eGFR population was 48.5%,light weight.The proportion of people with a drop in population was 47.1%,and the proportion of moderate to severe drop was 4.4%.Compared with group NGT,the proportion of eGFR normal population,the proportion of mild decrease and moderate to severe decrease in IGR group and DM group were significantly higher(P< 0.05).Compared with group IGR,the proportion of normal eGFR,the rate of mild decrease and the proportion of moderate to severe decrease in DM group were significantly higher than those in group IGR(P< 0.05).(3)There was significant difference in the proportion of patients with eGFR <60ml/min/1.73m2 between men and women in group IGR and group DM according to the age level(P< 0.05).(4)In the IGR population,according to the eGFR stratified analysis,it was found that compared with the normal eGFR group,the detection rate of stroke,coronary heart disease and MS in the mild and moderate eGFR group increased gradually(P< 0.05),and the detection rate of central obesity was higher in the moderate and severe eGFR decline group than in the mild decline group(P< 0.05),but with eGFR positive.Compared with the control group,there was no significant difference in the detection rate of central obesity in the mild eGFR group(P>0.05).However,there was no significant difference in the detection rate of myocardial infarction and fatty liver between eGFR normal group,eGFR mild group and moderate severe group(P> 0.05).(5)In the DM population,according to the eGFR stratified analysis,it was found that compared with the normal eGFR group,the detection rate of coronary heart disease and MS in the mild and moderate eGFR group increased gradually(P< 0.05),and the detection rate of stroke in the moderate and severe eGFR decreased group was significantly higher than that in the normal group and the mild decrease group(P< 0.05),but with eGFR,but with eGFR.Compared with the normal group,there was no significant difference in the detection rate of stroke in the mild eGFR group(P< 0.05).The detection rate of myocardial infarction,fatty liver and central obesity had no significant difference between the normal eGFR group,the mild eGFR decrease group and the moderate and severe decrease group(P>0.05).(6)In the general population,according to the eGFR stratified analysis,we found that compared with the normal group of eGFR,the age of mild eGFR,the detection rate of central obesity,the detection rate of stroke,the detection rate of cerebral apoplexy,the detection rate of coronary heart disease,the detection rate of MS,SBP,1hPG,BMI,waist circumference,FPG,2hPG,HbA1 c,Scr,LDL-C,etc.Compared with the mild decline group,the age,the detection rate of coronary heart disease,the SBP,the 2hPG,the blood Scr,the LDL-C,and the TG were all significantly increased in the severe decline group(P< 0.05),but the detection rate of central obesity,the detection rate of stroke,1hPG,BMI,waist circumference,FPG,HbA1 c were in the mild decline and severe decline in the eGFR.There was no significant difference between the groups(P>0.05).Compared with the normal eGFR group and the mild eGFR reduction group,the proportion of male and blood lipid disorders in the severe eGFR decreased group increased significantly,and the HDL-C decreased significantly(P< 0.05),but there was no significant difference in the proportion of male,blood lipid disorder and HDL-C in the normal eGFR group and the mild eGFR group(P>0.05).There was no significant difference in the detection rate of myocardial infarction,the detection rate of fatty liver,DBP,ALT,AST and gamma-GT between the three groups(P> 0.05).(7)Taking eGFR as the dependent variable,the independent variables of age,sex,BMI,waist circumference,SBP,DBP,TCH,TG,HDL-C,LDL-C,HbA1 c,1hPG,2hPG,Scr,1hPG and 2hPG were stepwise regression analysis.Increased age,LDL-C,waist circumference,and Scr levels can increase the risk of eGFR reduction in hyperglycemia,while HDL-C is an independent protective factor affecting the change of eGFR in hyperglycemia people.Conclusion:(1)With the increase of blood glucose level,the eGFR of people aged 40 or above in Hefei is decreasing.(2)Compared with the normal glucose tolerance group,the proportion of people with normal eGFR in the hyperglycemic group decreased,and the proportion of people with mild,moderate and severe falls increased.(3)In both IGR group and DM group,eGFR showed a decreasing trend of aging.(4)eGFR is closely related to stroke,coronary heart disease,MS,hypertension and lipid metabolism disorders,both in hyperglycemia and in the general population.(5)The independent risk factors of eGFR change in hyperglycemic group were age,LDL-C,waist circumference and HDL-C level.(6)controlling body weight,blood fat and blood pressure is of great significance for prevention and treatment of kidney disease in hyperglycemic population.