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张明, 刘杰, 汪嘉琦, 王丹, 刘佳莉, 覃玉, 张永青, 向全永. 吸烟对男性职业人群肾小球滤过率影响[J]. 中国公共卫生, 2023, 39(1): 32-35. DOI: 10.11847/zgggws1137947
引用本文: 张明, 刘杰, 汪嘉琦, 王丹, 刘佳莉, 覃玉, 张永青, 向全永. 吸烟对男性职业人群肾小球滤过率影响[J]. 中国公共卫生, 2023, 39(1): 32-35. DOI: 10.11847/zgggws1137947
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ZHANG Ming, LIU Jie, WANG Jia-qi, . Effect of smoking on estimated glomerular filtration rate in a male occupational population[J]. Chinese Journal of Public Health, 2023, 39(1): 32-35. DOI: 10.11847/zgggws1137947
Citation: ZHANG Ming, LIU Jie, WANG Jia-qi, . Effect of smoking on estimated glomerular filtration rate in a male occupational population[J]. Chinese Journal of Public Health, 2023, 39(1): 32-35. DOI: 10.11847/zgggws1137947
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吸烟对男性职业人群肾小球滤过率影响

Effect of smoking on estimated glomerular filtration rate in a male occupational population

    摘要
  • 摘要:
      目的  了解吸烟对男性职业人群肾小球滤过率（eGFR）的影响，为烟草控制及慢性肾脏疾病（CKD）的防治提供参考依据。
      方法  于2018年6月 — 2019年6月采用整群随机抽样方法在江苏省徐州市某大型国有企业抽取1760名男性职工进行问卷调查、体格检查和实验室检测；采用简化MDRD公式计算每名男性职工的eGFR，并应用多因素logistic回归模型分析吸烟对男性职业人群eGFR的影响。
      结果  男性职业人群的吸烟率和eGFR异常率分别为62.67 %和13.24 %；从不吸烟、轻度吸烟、中度吸烟和重度吸烟男性职业人群的eGFR分别为（123.42 ± 26.27）、（119.05 ± 23.54）、（113.72 ± 24.06）和（102.31 ± 24.86 ）mL/min/1.73 m2，男性职业人群的eGFR水平随吸烟量的增加而降低（F = 43.07，P < 0.001）；从不吸烟、轻度吸烟、中度吸烟和重度吸烟者的eGFR异常率分别为8.37 %、10.53 %、15.06 %和31.82 %，吸烟量与eGFR异常率间有显著的剂量 – 效应关系（χ2趋势 = 67.06，P趋势 < 0.001）；在调整了年龄、腰围、臀围、饮酒、收缩压、舒张压、空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和肌酐后，中度和重度吸烟男性职业人群的eGFR异常风险分别为不吸烟男性职业人群的1.67倍（OR = 1.67，95 % CI = 1.07～2.61）和3.36倍（OR = 3.36，95 % CI = 2.14～5.28），剔除新诊断高血压患者后中度和重度吸烟男性职业人群的eGFR异常风险分别为不吸烟男性职业人群的2.91倍（OR = 2.91，95 % CI = 1.50～5.64）和4.38倍（OR = 4.38，95 % CI = 2.13～9.00），剔除新诊断糖尿病患者后中度和重度吸烟男性职业人群的eGFR异常风险分别为不吸烟男性职业人群的1.68倍（OR = 1.68，95 % CI = 1.04～2.72）和3.78倍（OR = 3.78，95 % CI = 2.31～6.20）。
      结论  吸烟可降低男性职业人群的eGFR且呈显著的剂量 – 效应关系。

     

    Abstract:
      Objective  To investigate the effect of smoking on estimated glomerular filtration rate (eGFR) in a male occupational population for providing evidence to tobacco control and prevention of chronic kidney disease (CKD).
      Methods  A face-to-face questionnaire survey, physical examination and laboratory testing were conducted from June 2018 to June 2019 among 1 760 male employees recruited with cluster random sampling in a large state-owned enterprise in Xuzhou city, Jiangsu province. The simplified diet in renal disease (MDRD) formula was used to calculate eGFR of the participants and logistic regression analysis was adopted to analyze the effect of smoking (pack years) on eGFR.
      Results  For all the participants, the self-reported smoking rate was 62.67% and the detection rate of abnormal eGFR was 13.24%. The average eGFR (ml/min/1.73 m2) was 123.42 ± 26.27 for non-smokers and 119.05 ± 23.54, 113.72 ± 24.06, and 102.31 ± 24.86 for light, moderate, and heavy smokers, respectively; the eGFR decreased significantly with the increase of smoking quantity (F = 43.07, P < 0.001). The detection rate of abnormal eGFR was 8.37% in non-smokers and the rate was 10.53%, 15.06%, and 31.82% in light, moderate, and heavy smokers and there was a significant dose-effect relationship between smoking quantity and detection rate of abnormal eGFR (χ2 = 67.06, P < 0.001). After adjusting for age, waist circumference, hip circumference, alcohol drinking, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and creatinine and in comparison with the non-smokers, the risk of eGFR abnormality increased significantly in the moderate smokers (odds ratio OR = 1.67, 95% confidence interval 95% CI: 1.07 – 2.61) and in the heavy smokers (OR = 3.36, 95% CI: 2.14 – 5.28); when excluding the participants with newly diagnosed hypertension, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 2.91, 95% CI: 1.50 – 5.64) and heavy smokers (OR = 4.38, 95% CI: 2.13 – 9.00) compared to the non-smokers; while, excluding the participants with newly diagnosed diabetes, the risk of abnormal eGFR was significantly higher for the moderate smokers (OR = 1.68, 95% CI: 1.04 – 2.72) and heavy smokers (OR = 3.78, 95% CI: 2.31 – 6.20) contrasting to the non-smokers.
      Conclusion  Smoking can significantly reduce eGFR in dose-effect manner among male occupational people.

     

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