Relationship Between The Exposure To Cumulative Cardiovascular Health Behaviors And Factors And Chronic Kidney Disease-The Kailuan Study

PurposeTo explore the relationship between cumulative ideal cardiovascular health behaviors and factors and the incidence of chronic kidney disease and its related mechanisms.MethodsThis topic relies on the Kailuan study(registration number: Chi CTR-TNC-1101489).It began in 2006 and was observed by current and retired employees of the Kailuan group.The baseline database contains a total of 101,510 people.The study was certified by the ethics committee of the Kailuan general hospital.Firstly,examine the effect of the cumulative cardiovascular health score(CVH)and the incidence of chronic kidney disease(CKD).Using the longitudinal study method,the subjects who completed four health examinations were selected as observers,The exclusion :(1)incomplete data on CVH in the study;(2)individuals were diagnosed with CKD before 2012;(3)incomplete data on serum creatinine and proteinuria from the 2nd to 4th examinations.Continuous variables were presented using mean ± standard deviation(SD)and compared using one-way ANOVA or the rank-sum test.Categorical variables were presented as n(%)and compared using the chi-square test.Multivariate logistic regression analysis was used to analyze the factors affecting CKD,and presented as odds ratio(OR)and 95% confidence interval(CI).Two-sided P-values <0.05 were considered statistically significant.Secondly,investigate the relationship between CVH and serum high-sensitivity C-reactive protein(hs-CRP).Using a cross-sectional design,the participants in the 2006-2007 physical examination were selected as baseline information.The exclusion:(1)incomplete data related to the study;(2)myocardial infarction or stroke in the past;(3)recent surgical and traumatic history,infectious diseases,hematological diseases,severe liver disease,cardiac or renal failures,cancer or autoimmune diseases;immunomodulator use in the past 3 months;serum hs-CRP>10 mg/L.Categorical variables were presented as n(%)and compared using the chi-square test.The data according to the normal distribution were presented using mean ± standard deviation,and the T test was used for comparison between the two groups;The comparison among groups is based on single factor variance analysis(SNK method for comparison between two groups);Hs-CRP has a normal distribution after logarithmic conversion,hs-CRP3mg/L were used as a dichotomous variable to analyze the effects of CVH on hs-CRP levels by using binary logistic regression.Two-sided P-values <0.05 were considered statistically significant.Results1.27,970 individuals were included in the analyses.The CVH indicators were set to 2,1,and 0 point according to ideal,medium,and poor,and the cum CVH score was calculated.Participants were divided into five categories based on the quintiles of the cum CVH scores.The logistic regression analysis showed that with the increase of cum CVH,the frequency of CKD gets lower: 3.52%,2.06%,2.29%,1.95%,and 1.05%.After adjustment for the relevant factors,and compared with the first quintile,The ORs of cum CVH Q2-5 were 0.54,0.58,0.47,and 0.25.For each additional 1 point of exposure,the risk of CKD was reduced by 2%.Similar results were observed after stratification by gender and age.Each additional year lived with a 1-unit increase in ideal CVH was associated with a 11% reduction in new on-set CKD.2.A total of 93,967 cases met the selection criteria,of which 41,577 were in the hypertensive subgroup and 7869 in the diabetic subgroup.Participants were divided into six groups according to the number of ideal CVH in the general population and were divided into four groups in the hypertensive and diabetic subgroup.In the general population,hypertensive and diabetic subgroups,with the increase in the number of ideal CVH,the median hs-CRP gradually decreases.The median hs-CRP levels as following: 1.70mg/L,1.60mg/L,1.50mg/L,1.30mg/L,1.01mg/L,0.90mg/L and 1.11mg/L,0.96mg/L,0.90mg/L,0.80mg/L and 1.25mg/L,1.21mg/L,1.00mg/L,0.80mg/L respectively.Similar correlation was observed by gender.The logistic regression analysis confirmed that the risk of hs-CRP>3 mg/L remarkably declined with the increase in the number of ideal CVH.Conclusions1.The ideal CVH can significantly reduce the incidence of CKD,and the higher the cum CVH,the lower the risk of CKD.The protective effect is more obvious among men and the elderly.2.Increasing numbers of ideal CVH were associated with decreased hs-CRP levels and the risk of serum hs CRP>3 mg/L remarkably declined.Similar correlation was observed in different genders.