Relationship Between Estimated Glomerular Filtration Rate And Cardiovascular Disease In Xinjiang Uygur Residents

Objective:To investigate the relationship between estimated glomerular filtration rate（eGFR）and the risk of cardiovascular disease（CVD）in Xinjiang Uygur residents.It provides a reference for more accurate assessment of the risk of CVD in Uygur residents.Methods:This study adopts the design scheme of retrospective cohort study,and the representative regiment 51 which belong to the Third Division of Xinjiang Production and Construction Corps was selected as the study site,set 2016 as the baseline,and 2021 as the end,the cohort was followed up in 2019and 2020.Follow up the occurrence of outcome events through questionnaires,and confirm the outcome events through medical records,social security information and death registration of local hospitals.Excluding patients with CVD,creatinine data loss,kidney disease and incomplete baseline data,a total of5705 subjects were finally included.eGFR1,eGFR2 and eGFR3 was calculated by c-MDRD,CKD-EPI2021 and EKFC formulas.Using t test,nonparametric test andχ²test compare the baseline characteristics of the comparative study subjects;Cox regression model and restricted cubic spline were used to analyze the relationship between eGFR and CVD risk;Cox regression was used to analyze the combination and interaction effects of eGFR and traditional risk factors on CVD;The additive interaction between eGFR and traditional risk factors was analyzed by using relative super-risk ratio,attribution ratio and interaction index.Results:1.A total of 26578.69 person-years were followed up,with a median follow-up time of 4.90 years.During the follow-up period,570 cases of new CVD occurred,the cumulative incidence rate was 9.99%（570/5705）,the incidence density was 21.45/1000 person years（570/26578.69 person years）,and the average age was 39.28±13.09 years.The cumulative incidence rate of men（8.60%）was lower than that of women（11.38%）（P<0.05）.The average levels of eGFR1,eGFR2 and eGFR3 were 97.70±17.16m L/（min?1.73m²）,96.15±13.41 m L/（min?1.73m²）and 105.82±15.10 m L/（min?1.73m²）,respectively.2.In the total population,when eGFR1s were included in the model as continuous variables and adjusted by multiple factors,eGFRs were correlated with the risk of CVD,and their HR（95%CI）values were0.991（0.985,0.997）,0.989（0.982,0.995）and 0.991（0.984,0.999）,respectively.When eGFRs were included in the model as classification variables,after multifactorial adjustment,lower eGFR was risk factors for CVD,and their HR（95%CI）values were 1.426（1.181,1.721）,1.236（1.003,1.522）and 1.311（1.066,1.613）,respectively.3.The dose-response relationship between three kinds of eGFR and CVD incidence was analyzed with restricted cubic spline.The results showed that after adjusting for multiple factors,the three kinds of eGFR were non-linear correlated with the incidence risk of CVD(all P _nonlinear<0.001).4.There were positive multiplicative interaction between eGFR and SBP,overweight and obesity（P<0.05）,and there were additive interaction between eGFR and smoking,overweight and obesity.Conclusions:1.The eGFR（60～90m L/（min?1.73m²））was associated with the increased risk of CVD,and there was a nonlinear dose-response relationship between them.2.The interactions between eGFR and smoking,SBP,overweight and obesity can increase the risk of CVD.