广州医药2025，Vol.56Issue(8)：1061-1068,1086,9.DOI:10.20223/j.cnki.1000-8535.2025.08.007
基于NHANES数据库中年人群血清同型半胱氨酸水平与肾功能下降的阈值效应分析
Threshold effect of serum homocysteine level on kidney function decline among middle-aged adults in America based on NHANES database
摘要
Abstract
Objective Elevated serum homocysteine(Hcy)levels are linked to chronic kidney disease(CKD)progression,yet the nonlinear relationship in middle-aged populations remains underexplored.Methods This study analyzed data from 5 361 participants aged 45-65 years in the NHANES 1996-2006 cohort.Renal dysfunction was defined as an estimated glomerular filtration rate(eGFR)＜60 mL/min/1.73 m2 and urinary albumin-to-creatinine ratio(uACR)≥30 mg/g.Results Logistic regression and smoothed curve fitting revealed that each 1µmol/L increase in Hcy elevated the risk of reduced eGFR by 8%(OR=1.08,95%CI:1.06-1.10)and uACR by 2%(OR=1.02,95%CI:1.00-1.04).A nonlinear threshold effect was identified at 13.4µmol/L,with a stronger association below this threshold(OR=1.59,95%CI:1.49-1.70)and no significant effect above it.Subgroup analyses showed no interactions with gender or hypertension,but a stronger Hcy-eGFR association was observed in diabetics(interaction P=0.0158).Conclusions These findings suggest that controlling Hcy levels may mitigate renal decline,particularly in diabetic populations,warranting further causal investigations.关键词
血清同型半胱氨酸/肾功能下降/阈值效应/NHANESKey words
homocysteine/renal function decline/threshold effect/NHANES引用本文复制引用
何婷,彭晓辉,黄玉宇,王衍慧,连兴基,张兵..基于NHANES数据库中年人群血清同型半胱氨酸水平与肾功能下降的阈值效应分析[J].广州医药,2025,56(8):1061-1068,1086,9.基金项目
广州市科技市校(院)联合资助项目基础与应用基础研究项目(202201020512 （院）
202102010017) （）
广州市卫生健康科技一般引导项目(20221A011004) （20221A011004）
