摘要目的 探讨中国长寿地区≥65岁老年人估算肾小球滤过率(eGFR)与全因死亡率之间的关系.方法 数据来源于“中国老年健康影响因素跟踪调查”子队列—“老年健康生物标志物队列研究”,本研究共纳入2012年至2017/2018年的l 802名研究对象.根据eGFR水平将老年人分为4组:肾功能中-重度损伤组[＜45 ml·min-1· (1.73 m2)-1]、肾功能轻-中度损伤组[45～ml·rain-1· (1.73 m2)-1]、肾功能轻度损伤组[60～ml· min-1·(1.73 m2)-1]、肾功能正常组[≥90 ml·min-1·(1.73 m2)-1].采用Cox比例风险模型评估eGFR水平与死亡风险之间的关联.结果 经6年随访共计852人死亡,死亡率为47.3％.多因素Cox回归分析结果显示,eGFR水平与老年人全因死亡风险呈负相关[eGFR水平每升高1 ml·min-1· (1.73 m2)-1,老年人死亡HR=0.993,95％CI:0.989～ 0.997,P=0.001];相较于肾功能正常组,肾功能中-重度损伤组、轻-中度损伤组及轻度损伤组老年人死亡HR值(95％CI)分别为1.690(1.224～ 2.332,P=0.001)、1.312(0.978 ～ 1.758,P=0.070)、1.349(1.047～ 1.737,P=0.020)(趋势检验P＜0.001).结论 eGFR下降与中国长寿地区老年人群的高死亡风险相关.

abstractsObjective To investigate the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in the elderly aged 65 years and older in longevity areas in China.Methods Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study,a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey,1 802 elderly adults were collected in the study during 2012-2017/2018.In this study,the elderly were classified into 4 groups,moderate-to-severe group [＜45 ml· min-1· (1.73 m2)-1],mild-to-moderate group [45-ml· min-1 ·(1.73 m2)-1],mild group [60-ml· rain-1 · (1.73 m2)-1] and normal group [≥90 ml· min-1 · (1.73 m2)-1]according to their eGFR levels.Results After 6 years of follow-up,852 participants died,with a mortality rate of 47.3％.Multivariate Cox regression analysis showed that the levels of eGFR were negatively correlated with all-cause mortality risk in the elderly (the HR of elderly was 0.993 and the 95％CI was 0.989-0.997 for every unit of eGFR increased,P=0.001),while compared with the group with normal eGFR,the HRs (95％CI) of the elderly in the moderate-to-severe group,mild-to-moderate group,and mild group were 1.690 (1.224-2.332,P=0.001),1.312 (0.978-1.758,P=0.070),1.349(1.047-1.737,P=0.020) respectively [trend test P＜0.001].Conclusion The decrease in eGFR was associated with higher mortality risk among the elderly in longevity areas in China.