Subclinical kidney injury before and 1 year after bariatric surgery among adolescents with severe obesity.
Subclinical kidney injury before and 1 year after bariatric surgery among adolescents with severe obesity.
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严重肥胖青少年减肥手术前和术后 1 年的亚临床肾损伤。
DOI：
10.1002/oby.21070
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Mitsnefes,MarkM
中科院分区：
文献类型：
--
作者：
Xiao,Nianzhou;Devarajan,Prasad;Inge,ThomasH;Jenkins,ToddM;Bennett,Michael;Mitsnefes,MarkM
目的通过测量早期肾脏疾病的生物标志物来评估严重肥胖青少年的亚临床肾损伤，并评估这些生物标志物水平在减肥手术后的变化。在基线、术后6个月和12个月测量尿NGAL、IL-18和KIM-1。将生物标志物水平与44名年龄性别匹配的瘦controls.ResultsSubjects进行比较，肥胖患者的平均基线BMI为48 kg/m2，在1年随访时下降了34%。基线时，肥胖受试者的尿NGAL、IL-18和KIM-1显著高于瘦对照组。肥胖队列在6个月时NGAL和KIM-1进一步显著增加，随后在1年时下降。所有三个生物标志物的水平，通过1年手术后的整体变化，但是，是不显着的baseline.ConclusionsAdolescent严重肥胖与增加尿排泄的新的生物标志物的肾损伤，尽管没有微量白蛋白尿或肾功能下降。这种亚临床肾损伤在减肥手术诱导的显著体重减轻后持续1年，表明需要对这些青少年的肾脏状态进行密切、长期的随访。
ObjectiveTo assess subclinical kidney injury in adolescents with severe obesity by measuring biomarkers of early kidney disease and to assess changes in the levels of these biomarkers following bariatric procedures.MethodsTwenty‐two adolescents undergoing bariatric surgery with no microalbuminuria and normal kidney function were selected. Urinary NGAL, IL‐18, and KIM‐1 were measured at baseline, 6 and 12 months postoperatively. Biomarker levels were compared to 44 age‐gender‐matched lean controls.ResultsSubjects with obesity had a mean baseline BMI of 48 kg/m2that decreased by 34% at 1‐year follow‐up. Urine NGAL, IL‐18, and KIM‐1 were significantly elevated in subjects with obesity compared to lean controls at baseline. The obese cohort had a further significant increase in NGAL and KIM‐1 at 6 months, followed by decline at 1 year. The overall change in levels of all three biomarkers through 1 year after surgery, however, was not significant compared to baseline.ConclusionsAdolescent severe obesity is associated with increased urinary excretion of novel biomarkers of kidney injury, despite no microalbuminuria or decreased kidney function. This subclinical kidney injury persists 1 year after significant weight loss induced by bariatric surgery, suggesting that close, long‐term follow‐up of kidney status is warranted in these adolescents.
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DOI：
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发表时间：
1963
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DOI：
10.1056/nejm198111263052207
发表时间：
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