Obesity and change in estimated GFR among older adults.
Obesity and change in estimated GFR among older adults.
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DOI：
10.1053/j.ajkd.2009.07.018
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发表时间：
2009-12
期刊：
影响因子：
--
通讯作者：
Kestenbaum B
中科院分区：
文献类型：
--
作者：
de Boer IH;Katz R;Fried LF;Ix JH;Luchsinger J;Sarnak MJ;Shlipak MG;Siscovick DS;Kestenbaum B
慢性肾脏疾病的患病率在老年人中增长最快，但这一人群中肾功能受损的决定因素尚不清楚。在中年评估肥胖与慢性肾脏疾病有关。队列研究。4，295名参与者参加了基于社区的心血管健康研究，年龄≥ 65岁。使用生物电阻抗测量体重指数、腰围和脂肪量。7年随访期间肾小球滤过率（GFR）的变化。采用肾脏疾病饮食改良研究4变量方程计算GFR的纵向估计值。估计的GFR平均下降0.4 +/-3.6 mL/min/1.73 m2/年，693名参与者（16%）发生快速GFR损失（> 3 mL/min/1.73 m2/年）。基线体重指数、腰围和脂肪量均与GFR快速下降的风险增加相关：比值比（95%置信区间）1.19（1.09，1.30）/5 kg/m2，1.25（1.16，1.36）/12 cm和1.14（1.05，1.24）/10 kg。基线时估计GFR < 60 mL/min/1.73m2的参与者的风险增加幅度更大（相互作用p < 0.05）。通过进一步调整糖尿病、高血压和C反应蛋白，相关性大大减弱。肥胖测量与使用血清胱抑素C估计的GFR变化无关。很少有参与者在基线时患有晚期慢性肾病，没有直接的GFR测量。肥胖可能是老年人肾脏疾病发展和进展的一个可改变的风险因素。
The prevalence of chronic kidney disease is growing most rapidly among older adults, but determinants of impaired kidney function in this population are not well understood. Obesity assessed in mid-life has been associated with chronic kidney disease. Cohort study. 4,295 participants in the community-based Cardiovascular Health Study, ages >=65 years. Body mass index, waist circumference, and fat mass measured using bioelectrical impedance. Change in glomerular filtration rate (GFR) over 7 years of follow-up. Longitudinal estimates of GFR calculated with the 4-variable Modification of Diet in Renal Disease Study equation. Estimated GFR declined by an average of 0.4 +/− 3.6 mL/min/1.73m2/year, and rapid GFR loss (> 3 mL/min/1.73m2/year) occurred in 693 participants (16%). Baseline body mass index, waist circumference, and fat mass were each associated with increased risk of rapid GFR loss: odds ratios (95% confidence intervals) 1.19 (1.09, 1.30) per 5 kg/m2, 1.25 (1.16, 1.36) per 12 cm, and 1.14 (1.05, 1.24) per 10 kg, respectively, after adjustment for age, sex, race, and smoking. Magnitude of increased risk was larger for participants with estimated GFR < 60 mL/min/1.73m2 at baseline (p for interaction < 0.05). Associations were substantially attenuated by further adjustment for diabetes, hypertension, and C-reactive protein. Obesity measurements were not associated with change in GFR estimated using serum cystatin C. Few participants with advanced chronic kidney disease at baseline, no direct GFR measurements. Obesity may be a modifiable risk factor for the development and progression of kidney disease among older adults.
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影响因子：
13.2
作者：
Pinto-Sietsma, SJ;Navis, G;de Jong, PE
通讯作者：
de Jong, PE
影响因子：
13.2
作者：
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影响因子：
7.1
作者：
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通讯作者：
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影响因子：
158.5
作者：
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通讯作者：
Wood, JL
影响因子：
13.2
作者：
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通讯作者：
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