The status quo and influencing factors of renal impairment in the Uyghur population in southern Xinjiang
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摘要:
目的 了解新疆维吾尔自治区(新疆)南部维吾尔族人群肾功能损伤现状及其影响因素，为慢性肾脏病的早期发现和预防提供依据。 方法 选择2016年新疆生产建设兵团第三师51团≥18岁维吾尔族11 782人作为调查对象，利用问卷调查、体格检查和实验室检测的数据，采用χ 2检验和非参数检验分析肾功能损伤程度差别；采用有序多分类logistic回归分析模型分析肾功能发生损伤程度的影响因素。 结果 在新疆南部维吾尔族人群中，发生肾功能损伤所占比例为20.7%，其中轻度肾功能损伤所占比例为19.5%，中重度肾功能损伤所占比例为1.1%，性别(χ 2=-14.871, P＜0.001)、年龄(χ 2=884.842, P＜0.001)、腰高比(χ 2=-12.088, P＜0.001)、尿酸(uric acid, UA)(χ 2=-9.006, P＜0.001)、FBG(χ 2=-7.156, P＜0.001)、血脂异常(χ 2=-9.992, P＜0.001)、高血压(χ 2=-13.706, P＜0.001)、心血管疾病(cardiovascular disease, CVD)患病史(χ 2=-8.316, P＜0.001)、CVD家族史(χ 2=-2.490, P=0.013)、嗜盐(χ 2=-2.373, P=0.018)组间差异均有统计学意义。女性(OR=2.373, 95% CI: 2.144~2.627, P < 0.001)、高龄(OR=95.081, 95% CI: 63.375~142.651, P < 0.001)、高尿酸血症(OR=2.277, 95% CI: 1.726~3.004, P < 0.001)、血脂异常(OR=1.358, 95% CI: 1.222~1.508, P < 0.001)、CVD家族史(OR=1.302, 95% CI: 1.072~1.580, P=0.008)均会加重肾功能损伤的程度。 结论 新疆南部维吾尔族人群中女性、高龄、高尿酸血症、血脂异常、CVD家族史是肾功能损伤的相关因素，同时上述因素均会加重肾功能损伤的程度。建议对重点人群进行健康教育和同伴教育，提升该人群对慢性肾病的知晓率、治疗率和控制率。 Abstract:Objective To analyze the current status of estimated renal impairment in the Uygur population in southern Xinjiang and explore its influencing factors, in order to provide evidence for the early detection and prevention of chronic kidney disease. Methods A total of 11 782 Uyghurs over the age of 18 in the 51st Regiment of the Third Division of the Xinjiang Construction Corps in 2016 were selected as the survey subjects, and the data of a questionnaire survey, physical examination, and laboratory testing were used for analysis. The degree of renal injury distribution was described by the χ 2 test and nonparametric test. The ordinal multi-class logistic regression model was used to explore the influencing factors of renal function injury. Results Among the Uyghur population in southern Xinjiang, 20.7% had renal impairment, of which 19.5% had a mild renal impairment and 1.1% had moderate to severe renal impairment. There were significant differences in gender (χ 2=-14.871, P < 0.001), age (χ 2=884.842, P < 0.001), waist-to-height ratio (χ 2=-12.088, P < 0.001), uric acid (UA) (χ 2=-9.006, P < 0.001), fasting blood glucose (FBG) (χ 2=-7.156, P < 0.001), dyslipidemia (χ 2=-9.992, P < 0.001), hypertension (χ 2=-13.706, P < 0.001), cardiovascular disease (CVD) history (χ 2=-8.316, P < 0.001), CVD family history (χ 2=-2.490, P=0.013), and salt addiction (χ 2=-2.373, P=0.018). Being female (OR=2.373, 95% CI: 2.144-2.627, P < 0.001), of advanced age (OR=95.081, 95% CI: 63.375-142.651, P < 0.001), having hyperuricemia (OR=2.277, 95% CI: 1.726-3.004, P < 0.001), dyslipidemia (OR=1.358, 95% CI: 1.222-1.508, P < 0.001), and family history of CVD (OR=1.302, 95% CI: 1.072-1.580, P=0.008) were factors that aggravated the degree of renal damage. Conclusions In the Uyghur population in southern Xinjiang, being female, of advanced age, having hyperlipidemia, dyslipidemia, and a family history of CVD are influencing factors of renal impairment, which aggravated renal impairment. It is recommended to carry out health education and peer education for key groups to improve the awareness rate, treatment rate, and control rate of chronic kidney disease in this group. -
Key words:
- Uygur /
- Estimated glomerular filtration rate /
- Influencing factors
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表 1 维吾尔族人群中肾功能损伤发生情况
Table 1. Occurrence of renal function damage in Uyghur population
项目 Factor 人数 Number of people 肾功能损伤① Renal function damage ① 肾功能损伤程度① Degree of renal function damage ① 轻度 Mild 中重度 Moderate to severe 性别 Sex 男性 Male 5 894 893(15.2) 850(14.4) 43(0.7) 女性 Female 5 888 1 544(26.2) 1 453(24.7) 91(1.5) 年龄组/岁 Age group/years 18~ < 30 3 298 229(6.9) 207(6.3) 22(0.7) 30~ < 45 4 762 730(15.3) 697(14.6) ― 45~ < 60 2 627 812(30.9) 783(29.8) 29(1.1) 60~ < 75 970 550(56.7) 516(53.2) 34(3.5) ≥75 125 116(92.8) 100(80.0) 16(12.8) 婚姻状况 Marital status 已婚 Married 9 641 2 008(20.8) 1 904(19.7) 104(1.1) 单身/离异/丧偶 Single/Divorce/Widow 2 141 429(20.0) 399(18.6) 30(1.4) 职业 Occupation 农民/牧民 Farmers/Herders 9 524 1 942(20.4) 1 838(19.3) 104(1.1) 其他 Other 2 258 495(21.9) 465(20.6) 30(1.3) 受教育程度 Education level 初中及以下 Junior middle school or below 10 552 2 202(20.9) 2 080(19.7) 122(1.2) 高中及以上 Senior middle school or above 1 230 235(19.1) 223(18.1) 12(1.0) 注：“―”表示30~ < 45年龄组中没有中重度肾损伤。①以[人数(占比/%)]表示。Note: "―" refers there was no moderate to severe kidney injury in the 30- < 45 age group.① [Number of people (proportion /%)]. 
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表 2 维吾尔族人群肾功能损伤程度的单因素分析
Table 2. Univariate analysis of the degree of renal damage in the Uygur population
因素 Factor 人数 Number of people 肾功能损伤 Renal function damage 无[人数(占比/%)] No [Number of people (proportion /%)] 轻度[人数(占比/%)] Mild [Number of people (proportion /%)] 中重度[人数(占比/%)] Moderate to severe [Number of people (proportion /%)] χ2/Z值χ2/Z value P值P value 性别 Sex -14.871 ＜0.001 男性 Male 5 894 5 001(84.8) 850(14.4) 43(0.7) 女性 Female 5 888 4 344(73.8) 1 453(24.7) 91(1.5) 年龄组/岁 Age group/years 884.842 ＜0.001 18~ < 30 3 298 3 069(93.1) 207(6.3) 22(0.7) 30~ < 45 4 762 4 032(84.7) 697(14.6) 33(0.7) 45~ < 60 2 627 1 815(69.1) 783(29.8) 29(1.1) 60~ < 75 970 420(43.3) 516(53.2) 34(3.5) ≥75 125 9(7.2) 100(80.0) 16(12.8) 婚姻状况 Marital status -0.737 0.461 已婚 Married 9 641 7 633(79.2) 1 904(19.7) 104(1.1) 单身/离异/丧偶 Single/Divorce/Widow 2 141 1 712(80.0) 399(18.6) 30(1.4) 职业 Occupation -1.646 0.100 农民/牧民 Farmers/Herders 9 524 7 582(79.6) 1 838(19.3) 104(1.1) 其他 Other 2 258 1 763(78.1) 465(20.6) 30(1.3) 受教育程度 Education level -1.456 0.145 初中及以下 Junior middle school or below 10 552 8 350(79.1) 2 080(19.7) 122(1.2) 高中及以上 Senior middle school or above 1 230 995(80.9) 223(18.1) 12(1.0) 腰高比 Waist-height ratio -12.088 ＜0.001 < 0.5 3 057 2 658(87.0) 377(12.3) 22(0.7) ≥0.5 8 725 6 687(76.6) 1 926(22.1) 112(1.3) UA -9.006 ＜0.001 正常 Normal 11 535 9 204(79.8) 2 212(19.2) 119(1.0) 高尿酸血症 Hyperuricemia 247 141(57.1) 91(36.8) 15(6.1) FPG/(mmol·L-1) -7.156 ＜0.001 < 7.0 11 052 8 841(80.0) 2 094(18.9) 117(1.1) ≥7.0 730 504(69.1) 209(28.6) 17(2.3) 血脂异常 Dyslipidemia -9.992 ＜0.001 否 No 8 174 6 684(81.8) 1 418(17.3) 72(0.9) 是 Yes 3 608 2 661(73.8) 885(24.5) 62(1.7) 高血压 Hypertension -13.706 ＜0.001 否 No 8 385 6 921(82.5) 1 398(16.7) 66(0.8) 是 Yes 3 397 2 424(71.4) 905(26.6) 68(2.0) CVD患病史 Disease history of CVD -8.316 ＜0.001 否 No 11 423 9 121(79.9) 2 186(19.1) 116(1.0) 是 Yes 359 224(62.4) 117(32.6) 18(5.0) CVD家族史 Family history of CVD -2.490 0.013 否 No 11 082 8 816(79.6) 2 140(19.3) 126(1.1) 是 Yes 700 529(75.6) 163(23.3) 8(1.1) 嗜盐 Halophilic -2.373 0.018 否 No 3 683 2 970(80.7) 672(18.2) 41(1.1) 是 Yes 8 099 6 375(78.8) 1 631(20.1) 93(1.1) 运动习惯 Exercise habits -0.658 0.511 缺乏运动 Lack of exercise 10 552 8 379(79.4) 2 050(19.4) 123(1.2) 规律运动 Regular exercise 1 230 966(78.5) 253(20.6) 11(0.9) 注：UA, 尿酸；FPG, 空腹血糖；CVD, 心血管疾病。
Note: UA, uric acid; FPG, fasting plasma glucose; CVD, cardiovascular disease.
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表 3 有序分类logistic回归分析模型分析的变量赋值表
Table 3. Variable assignment table for ordinal logistic regression model
因素 Factor 变量名 Variable name 赋值说明 Assignment description 性别 Sex X1 男性=1，女性=2 Male=1, Female=2 年龄组/岁 Age group/years X2 18~ < 30=1，30~ < 45=2，45~ < 60=3，60~ < 75=4，≥75=5 腰高比 Waist-height ratio X3 ＜0.5=0，≥0.5=1 UA X4 正常=0，高尿酸血症=1 Normal=0, Hyperuricemia=1 FPG/(mmol·L-1) X5 ＜7.0=0，≥7.0=1 血脂异常 Dyslipidemia X6 否=0，是=1 No=0, Yes=1 高血压 Hypertension X7 否=0，是=1 No=0, Yes=1 CVD患病史 Disease history of CVD X8 否=0，是=1 No=0, Yes=1 CVD家族史 Family history of CVD X9 否=0，是=1 No=0, Yes=1 嗜盐 Halophilic X10 否=0，是=1 No=0, Yes=1 肾功能损伤程度 Degree of renal function damage Y 否[eGFR≥90 mL/(min·1.73 m2)]=0，轻度[60 mL/(min·1.73 m2)≤eGFR < 90 mL/(min·1.73 m2)]=1，中重度[eGFR < 60 mL/(min·1.73 m2)]=2 No [eGFR≥90 mL/(min·1.73 m2)]=0, Mild [60 mL/(min·1.73 m2)≤eGFR < 90 mL/(min·1.73 m2)]=1, Moderate to severe [eGFR < 60 mL/(min·1.73 m2)]=2 注：UA, 尿酸；FPG, 空腹血糖；CVD, 心血管疾病。
Note: UA, uric acid; FPG, fasting plasma glucose; CVD, cardiovascular disease.
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表 4 维吾尔族人群肾功能损伤的有序分类logistic回归分析模型分析
Table 4. Ordinal logistic regression model of renal damage in Uyghur population
因素 Factor β Wald值 Wald value OR值(95% CI) OR value (95% CI) P值 P value 性别 Sex 0.864 278.388 2.373(2.144~2.627) ＜0.001 年龄组/岁 Age group/years 18~ < 30 1.000 30~ < 45 0.789 92.738 2.202(1.875~2.586) ＜0.001 45~ < 60 1.628 364.420 5.092(4.308~6.018) ＜0.001 60~ < 75 2.786 773.563 16.217(13.326~19.734) ＜0.001 ≥75 4.555 484.264 95.081(63.375~142.651) ＜0.001 腰高比Waist-height ratio 0.108 2.623 1.114(0.978~1.270) 0.105 UA 0.823 33.860 2.277(1.726~3.004) ＜0.001 FBG/(mmol·L-1) 0.179 3.668 1.196(0.996~1.437) 0.055 血脂异常Dyslipidemia 0.306 32.485 1.358(1.222~1.508) ＜0.001 高血压Hypertension 0.069 1.571 1.072(0.962~1.194) 0.210 CVD患病史Disease history of CVD 0.132 1.147 1.142(0.896~1.455) 0.284 CVD家族史Family history of CVD 0.264 7.107 1.302(1.072~1.580) 0.008 嗜盐Halophilic 0.049 0.820 1.051(0.944~1.169) 0.365 注：UA, 尿酸；FPG, 空腹血糖；CVD, 心血管疾病。
Note: UA, uric acid; FPG, fasting plasma glucose; CVD, cardiovascular disease.
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