心脏代谢指数与功能受损有关:国家队列中的非线性值效应和剂量反应关系 (NHANES 1999-2018)
Zhengyang Zhu1, Kejun Ren2, Xiaowei Duan2
1Department of Postgraduate, First Clinical Medical College, Anhui University of Chinese Medicine, Hefei, Anhui Province, China.
Medicine
|August 5, 2025
概括
心脏代谢指数 (CMI) 是降低功能的一个新型预测指标,即使在慢性病 (CKD) 的早期阶段也是如此. 较高的CMI水平与估计膜过率 (eGFR) 损伤的概率增加有关,突出其早期CKD检测的潜力.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 代谢健康 代谢健康
背景情况:
- 精确评估功能对于管理慢性病 (CKD) 至关重要.
- 估计的膜过率 (eGFR) 是标准的,但它在检测早期代谢功能障碍方面存在局限性.
- 心脏代谢指数 (CMI) 是对代谢失调的衡量标准,以前没有与eGFR定义的功能障碍有关.
研究的目的:
- 调查心脏代谢指数 (CMI) 与由eGFR定义的功能下降之间的关联.
- 探索CMI作为补充生物标志物的潜力,用于早期检测代谢驱动的功能障碍.
主要方法:
- 从国家健康和营养检查调查 (1999-2018) 中对13696名美国成年人的横截面分析.
- 使用2021年CKD-EPI肌素方程计算eGFR; 降低功能被定义为eGFR<60毫升/分钟/1.73m2.
- 通过结合甘油三和高密度胆固醇的比率和腰与身高的比率来计算CMI;采用加权多变量后勤回归和受限立方脊线分析.
主要成果:
- 较高的CMI五分位数显示,降低EGFR的患病率有剂量依赖的增加 (Q1的5.3%,Q5的23.8%,P<.001).
- 完全调整的模型显示,在最高CMI五分位数 (OR 2.16,95%CI:1.27-3.69) 中,降低EGFR的几率较高.
- 在CMI = 0.182时,确定了非线性值效应,在这个值以下和以上显著增加风险.
结论:
- 较高的CMI独立地预测了功能下降,这表明它作为早期CKD检测的代谢生物标志物的实用性.
- 确定的值 (CMI ≥0.182) 为临床风险分层提供了一个关键点.
- 将CMI纳入常规查可能有助于预防代谢驱动的功能障碍.
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