摘要目的:探讨南京市老年人（≥65岁）空腹血糖（FPG）轨迹与新发慢性肾脏病（CKD）的相关性。方法:以南京市老年健康体检人群中符合入选标准的14 763例研究对象组成研究队列，依据研究对象2018-2021年健康体检得到FPG（取对数使其服从正态分布）水平，采用SAS Proc Traj程序确定不同的FPG轨迹组，分别为低、中、高3个稳定组，于2022年随访各组CKD的发病情况，采用log-rank检验比较不同轨迹组CKD累积发病率的差异，采用Cox比例风险回归模型分析不同FPG轨迹组与新发CKD的相关性。结果:随访时间为（416.09±81.96）d，选取随访时间500 d分析不同FPG轨迹组CKD的累积发病率，FPG低、中、高稳定组的CKD累积发病率呈逐渐升高趋势，分别为15.3%、21.8%、29.3%，经log-rank检验差异有统计学意义（ χ2=151.16， P<0.001）。Cox比例风险回归模型分析结果显示，与低稳定组相比，中、高稳定组均为新发CKD的危险因素。经过调整多种混杂因素后，中、高稳定组CKD发病风险仍为低稳定组的1.676（95% CI：1.462~1.921）倍和2.007（95% CI：1.562~2.579）倍。 结论:FPG轨迹水平升高是新发CKD的危险因素，FPG的持续高水平会增加CKD的发病风险，应随访监测老年人的FPG指标，针对不同轨迹组人群制定个性化的CKD防治措施。

abstractsObjective:To explore the correlation between fasting plasma glucose (FPG) trajectory and new-onset chronic kidney disease (CKD) in elderly population (≥65 years old) in Nanjing.Methods:The study cohort was composed of 14 763 subjects who met the inclusion criteria in the population in elderly health examination in Nanjing. Based on the FPG levels detected in health examination from 2018 to 2021 (logarithm was used for normal distribution), three different FPG trajectory groups were determined using the SAS Proc Traj program, i.e. low-stable group, medium-stable group, and high-stable group. The incidence of CKD in 2022 was analyzed, and log-rank test was performed to compare the differences of cumulative incidence of new-onset CKD among different trajectory groups. Cox proportional hazards regression model was used to analyze the correlation between different FPG trajectories and new-onset CKD.Results:The mean follow-up time was (416.09±81.96) days. The follow-up time of the 500 th day was selected to analyze the cumulative incidence rate of CKD in different FPG trajectory groups, and the cumulative incidence rate of CKD in the low-stable group, the medium-stable group, and the high-stable group of FPG increased with elevated trajectory, which was 15.3%, 21.8%, and 29.3%, respectively (log-rank test χ2=151.16, P<0.001). Cox proportional hazards regression model analysis showed that compared with the low-stable group, the medium-stable group and the high-stable group were all at risk for new-onset CKD. After adjusting for multiple confounding factors, the analysis by Cox proportional hazards regression model 4 indicated that the risk for CKD in medium-stable and high-stable groups were still 1.676 (95% CI: 1.462-1.921) times and 2.007 (95% CI: 1.562-2.579) times higher than that in low-stable group. Conclusions:Elevated FPG change trajectory level is a risk factor for new-onset CKD, and persistently high level of FPG increase the risk for CKD. FPG should be monitored in elderly population by follow up, and individualized prevention and control measures for CKD should be developed for different trajectory groups.