Overweight, obesity, and elevated serum cystatin C levels in adults in the United States
Overweight, obesity, and elevated serum cystatin C levels in adults in the United States
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DOI：
10.1016/j.amjmed.2008.01.003
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发表时间：
2008-04-01
影响因子：
5.9
通讯作者：
Fox, Caroline S.
中科院分区：
文献类型：
--
作者：
Muntner, Paul;Winston, Jonathan;Fox, Caroline S.
背景技术背景：虽然高体重指数（BMI）是高血压、糖尿病和心血管疾病的危险因素，但关于超重和肥胖与早期肾脏疾病之间关系的数据有限。全国代表性的第三次全国健康与营养检查调查的5083名参与者的横截面数据，估计肾小球滤过率>= 60 mL/min/1.73 m（2）无微量或大量白蛋白尿的患者进行分析，以确定BMI与血清胱抑素C升高之间的关系。正常体重、超重、I级肥胖和II至III级肥胖分别定义为BMI为18.5至24.9 kg/m2、25.0至29.9 kg/m2、30.0至34.9 kg/m2和≥ 35.0 kg/m2。血清胱抑素C升高定义为>= 1.09 mg/L（>= 20-39岁的参与者的第99百分位数，没有糖尿病、高血压、微量或大量白蛋白尿或3-5期慢性肾脏疾病）。在正常体重、超重、I级肥胖、和II至III级肥胖（P趋势<0.001）。在对人口统计学、行为、收缩压和血清生物标志物进行多变量校正后，与正常体重的受试者相比，血清胱抑素C升高的95%可信区间为1.46超重组为1.02-2.10，I级肥胖组为2.36（1.56-3.57），II ~ III级肥胖组为2.82（1.56-5.11）。进一步的研究是必要的，以评估是否降低BMI有利地影响血清胱抑素C升高和慢性肾脏疾病的发展。(C)2008年爱思唯尔公司All rights reserved.
BACKGROUND: Although high body mass index (BMI) is a risk factor for hypertension, diabetes, and cardiovascular disease, limited data exist on the association of overweight and obesity with early stages of kidney disease.METHODS: Cross-sectional data for 5083 participants of the nationally representative Third National Health and Nutrition Examination Survey with an estimated glomerular filtration rate >= 60 mL/min/1.73 m(2) without micro- or macroalbuminuria were analyzed to determine the association between BMI and elevated serum cystatin C. Normal weight, overweight, class I obesity, and class II to III obesity were defined as a BMI of 18.5 to 24.9 kg/m(2), 25.0 to 29.9 kg/m(2), 30.0 to 34.9 kg/m(2), and >= 35.0 kg/m(2), respectively. Elevated serum cystatin C was defined as >= 1.09 mg/L (>= 99th percentile for participants 20-39 years of age without diabetes, hypertension, micro-or macroalbuminuria, or stage 3-5 chronic kidney disease).RESULTS: The age-standardized prevalence of elevated serum cystatin C was 9.6%, 12.9%, 17.4%, and 21.5% among adults of normal weight, overweight, class I obesity, and class II to III obesity, respectively (P trend < .001). After multivariate adjustment for demographics, behaviors, systolic blood pressure, and serum biomarkers, and compared with participants of normal weight, the odds ratio (95% confidence interval) of elevated serum cystatin C was 1.46 (1.02-2.10) for overweight, 2.36 (1.56-3.57) for class I obesity, and 2.82 (1.56-5.11) for class II to III obesity.CONCLUSION: A graded association exists between higher BMI and elevated serum cystatin C. Further research is warranted to assess whether reducing BMI favorably affects elevated serum cystatin C and the development of chronic kidney disease. (C) 2008 Elsevier Inc. All rights reserved.