JAHA:血红蛋白、蛋白尿和肾功能与心血管风险!

2018-01-12 xing.T MedSci原创

由此可见,肾功能、蛋白尿和贫血与CVD风险独立相关。蛋白尿与高血红蛋白对动脉粥样硬化性CVD的相关性及潜在的相互作用值得进一步研究。

估计的肾小球滤过率(eGFR)降低和尿白蛋白/肌酐比值(ACR)增大都会单独增加心血管疾病(CVD)的风险。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究推测在血红蛋白水平异常(降低和升高)的人群中这种相关性会更强。

研究人员纳入了社区动脉粥样硬化风险(ARIC)研究中的5801例血红蛋白指标可用的参与者,研究人员探讨了eGFR和ACR与血红蛋白水平之间的横断面相关性,以及与心血管疾病(心力衰竭、冠心病、卒中)风险之间的纵向相关性。

在基线时,8.8%的受试者存在贫血(男性<13g/dL,女性<12g/dL)和7.2%的受试者存在高血红蛋白血症(男性≥16g/dL, 女性≥15g/dL)。eGFR为30-59ml/min/1.73m2的受试者与≥90 ml/min/1.73m2的受试者相比,调整后贫血的患病率比为2.12(95%可信区间为1.59-2.82);ACR≥30mg/g的受试者与ACR<10mg/g的受试者相比,调整后贫血的患病率比为1.45(1.07-1.95)。ACR≥30mg/g也与高血红蛋白相关(患病率比为1.57[1.12-2.19],相比于ACR<10mg/g的受试者)。在随访期间,在5098例基线无CVD的参与者中有1069例参与者发生CVD。在多变量Cox模型中,较低eGFR、较高ACR以及贫血分别与CVD风险独立相关,较低eGFR与CVD之间的相关性在贫血患者中有所增强(相互作用P=0.072)。血红蛋白与ACR之间无相互作用;然而,当单独分析CVD亚型时,冠心病和卒中风险与高ACR之间的相关性在高血红蛋白患者中稍有增强(相互作用P<0.074)。

由此可见,肾功能、蛋白尿和贫血与CVD风险独立相关。蛋白尿与高血红蛋白对动脉粥样硬化性CVD的相关性及潜在的相互作用值得进一步研究。

原始出处:

Junichi Ishigami,et al. Hemoglobin, Albuminuria, and Kidney Function in Cardiovascular Risk: The ARIC (Atherosclerosis Risk in Communities) Study.JAHA.2018. https://doi.org/10.1161/JAHA.117.007209

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    2018-10-26 yese
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    2018-01-21 jyzxjiangqin

    血红蛋白和肾功能.

    0

  4. 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topicName=肾功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28d456, createdName=yese, createdTime=Fri Oct 26 10:57:00 CST 2018, time=2018-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280535, encodeId=21b42805353f, content=血红蛋白和肾功能., beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Jan 21 07:19:33 CST 2018, time=2018-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267687, encodeId=4a0e126e687fd, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Jan 12 22:33:40 CST 2018, time=2018-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277938, encodeId=41f52e793891, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5KiblTyxD95ExbzUoCVcRuhPibXboL28wicFMTXUhCA0RWCyQZYC5Na3ap7CxjialMkB50VEJ0XToQQTC/0, createdBy=470c1945776, createdName=方舒, createdTime=Fri Jan 12 22:11:28 CST 2018, time=2018-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=277936, encodeId=d9502e793691, content=...., beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-14 zhaohui6731
  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 衣带渐宽

    学习

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 zzl0611_64089391

    学习了

    0

  7. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 aa6081

    学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2082441, encodeId=fce22082441fe, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Sat Apr 07 04:57:00 CST 2018, time=2018-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1850651, encodeId=c34d1850651cc, content=<a href='/topic/show?id=46c682469e4' target=_blank style='color:#2F92EE;'>#肾功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82469, encryptionId=46c682469e4, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 有备才能无患

    估计的肾小球滤过率(eGFR)降低和尿白蛋白/肌酐比值(ACR)增大都会单独增加心血管疾病(CVD)的风险.近日.心血管疾病领域权威杂志JAHA上发表了一篇研究文章.研究推测在血红蛋白水平异常(降低和升高)的人群中这种相关性会更强.

    0

  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 方舒

    学习

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0aa31415219, createdName=orangesking, createdTime=Fri Jan 12 21:50:25 CST 2018, time=2018-01-12, status=1, ipAttribution=)]
    2018-01-12 orangesking

    ....

    0

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据发表于Journal of the American Heart Association 的一项新的研究表明,贫血增加了老年患者中风的死亡率。小M对此进行了整理,具体研究如下: 背景与目的 目前对于血红蛋白的水平和贫血对脑卒中死亡率的影响仍存在争议。本研究旨在系统性评估二者之间的关联并量化研究证据。 方法和结果 使用英国区域性卒中登记册,研究人员共分析了8013名卒中患者

J Diabetes Invest:采用DPP4抑制剂降血糖,注意这一点可能是成败的关键!

根据11月24日在线发表在糖尿病调查上的一项研究,对于2型糖尿病(T2D)患者,脂肪摄入可能会导致二肽基肽酶-4抑制剂(DPP4i)单药治疗中血红蛋白A1c(HbA1c)水平的下降。

Crit Care:急性脑损伤患者血红蛋白浓度和红细胞输注阈值的国际调查!

由此可见,其中一半的ICU临床医生认为急性脑损伤后红细胞输血的血红蛋白阈值应小于8克/分升,然而,超过50%的医生在某些情况下使用较高的血红蛋白阈值。

KIDNEY INT:血液透析儿童血红蛋白12g/dl以上与心血管疾病死亡率增加无关!!!

对进行血液透析的儿童,血红蛋白12g/dl以上与心血管疾病就诊率、死亡率增加不存在相关性,或与心血管疾病的全因死亡率和心血管疾病相关的住院治疗率无关。

J Intern Med:骨钙蛋白会影响血红蛋白?

既往的研究表明,成骨细胞参与造血干细胞的调控。而来自于成骨细胞具有代谢活性的骨钙蛋白,是否会影响血液中的血红蛋白(Hb)水平呢? 本研究旨在探究,老年男性血浆中的骨钙蛋白是否是血红蛋白的决定因素之一。 研究共纳入993名男性(平均年龄75.3±3.2岁),均来自以人群为基础的MrOS(男性骨质疏松性骨折)研究。分析中校正的混杂因素包括年龄、体重指数、促红细胞生成素、雌二醇总量、空腹胰岛

Sci Rep:新诊断的贫血增加帕金森病的风险

贫血和低血红蛋白已被确定可增加帕金森氏病(PD)的风险。利用台湾全民健康保险研究数据库的数据,研究基于人群的队列中新确诊的贫血的患者发生PD的风险。所有新诊断的贫血患者(n = 86334  )无卒中病史、神经退行性疾病、脑外伤、大手术、或出血性疾病。一组为非贫血患者为对照组,在人口统计学和预先存在的医疗条件的基础上,按照1:1与贫血患者进行配对。竞争风险分析评估贫血患者和对照组PD发生的风险。贫