最老年人群中的功能和全因死亡率:一项三队列纵向研究
Hideaki Kurata1, Shu Meguro2, Yukiko Abe3
1Division of Endocrinology, Metabolism and Nephrology Department of Internal Medicine, School of Medicine, Keio University, Shinjuku-Ku, Tokyo, Japan.
GeroScience
|February 9, 2026
概括
通过估计的膜过率 (eGFR) 测量功能,是老年人死亡率的重要预测因素. 慢性病 (CKD) 的特定年龄值是必要的,以便在百岁老人和超百岁老人的确切预后.
科学领域:
- 老年学和老年医学是老年学和老年医学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
背景情况:
- 全球预期寿命正在增加,需要更清楚地了解老年人群中功能预后价值.
- 慢性病 (CKD) 的常规估计球透率 (eGFR) 值可能不适合百岁老人和超百岁老人.
- 需要适应年龄的功能定义,以准确评估极端长寿的健康风险.
研究的目的:
- 调查不同年龄段的功能和全因死亡率之间的关联,重点关注非常老年人.
- 确定当前的CKD的eGFR值是否准确地预测了百岁老人和超百岁老人的死亡率.
- 在85岁及以上的个体中建立特定年龄的eGFR预后值.
主要方法:
- 分析了来自东京百岁老人研究,日本半超百岁老人研究和川崎老龄化与福祉项目的数据,其中包括1918名基线血清肌素水平的参与者.
- 使用肌素和囊素C计算eGFR,按照日本病学学会的方程.
- 使用考克斯回归模型评估死亡率关联,并估计标准化三年绝对风险.
主要成果:
- 较低的基于cystatin C的eGFR始终与较高的全因死亡率有关,而基于肌素的eGFR显示出较弱的关联.
- 预后eGFR值随着年龄的增长而下降:大约45mL/min/1.73m2为85-89岁,30mL/min/1.73m2为100-104岁,15mL/min/1.73m2为≥105岁.
- 低EGFR组与高EGFR组之间的绝对风险死亡率差异因年龄而异,在年轻的老年人中是适度的,在百岁老人中更大,在超级百岁老人中减弱.
结论:
- 估计的膜过率仍然是死亡率的相关预后标志物,即使在晚年.
- 与eGFR相关的预后意义和绝对风险差异在极端年龄组之间差异很大.
- 支持采用特定年龄的CKD值,以提高百岁老人和超百岁老人的预后准确性.
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