A central body fat distribution is related to renal function impairment, even in lean subjects
A central body fat distribution is related to renal function impairment, even in lean subjects
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DOI：
10.1016/s0272-6386(03)00020-9
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发表时间：
2003-04-01
影响因子：
13.2
通讯作者：
de Jong, PE
中科院分区：
文献类型：
--
作者：
Pinto-Sietsma, SJ;Navis, G;de Jong, PE
超重和肥胖被认为与肾损害有关。这是否取决于脂肪分布尚不清楚。我们推测，除了超重，脂肪分布可能与肾功能异常。研究方法：我们研究了7,676名无糖尿病的受试者的体重和脂肪分布与微量白蛋白尿和滤过率升高或降低之间的关系。微量白蛋白尿定义为尿白蛋白排泄（UAE）30 - 300 mg/24 h。滤过率升高和降低定义为非糖尿病瘦型组的滤过率± 2 SD，外周脂肪分布和UAE为0 - 15 mg/24 h，经年龄和性别校正。根据体重（超重定义为体重指数[BMI] > 25且小于或等于30 kg/m2;肥胖定义为BMI > 30 kg/m2）和脂肪分布，将总人口分为六组。结果如下：在逻辑回归分析中，中心脂肪分布的肥胖受试者发生微量白蛋白尿的风险更大（相对风险为1.7; 95%可信区间为1.19 - 2.35）。外周或中心脂肪分布的肥胖受试者滤过率升高的风险更大（相对风险，3.2; 95%置信区间，1.19 - 8.47;相对风险，2.6; 95%置信区间，1.59 - 4.28）。此外，中心脂肪分布的受试者，无论是瘦的，超重的，还是肥胖的，都有更大的滤过减少的风险。（相对风险，1.9; 95%置信区间，1.19至3.12;相对风险，2.0; 95%置信区间，1.19至3.19;相对风险，2.7; 95%置信区间，分别为1.46至4.85）。最后，通过将腰臀比（WHR）分为四分位数，即使校正了BMI，更大的WHR与更大的滤过减少风险相关。结论：不仅超重和肥胖受试者，而且中心脂肪分布的瘦受试者也有滤过减少的风险。因此，脂肪分布的中心模式，而不是超重或肥胖本身，似乎对肾损害很重要。(C)2003年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background Overweight and obesity are believed to be associated with renal damage. Whether this depends on fat distribution is not known. We hypothesize that in addition to overweight, fat distribution may be associated with renal function abnormalities. Methods: We studied the relation between body weight and fat distribution and microalbuminuria and elevated or diminished filtration in 7,676 subjects without diabetes. Microalbuminuria is defined as urinary albumin excretion (UAE) of 30 to 300 mg/24 h. Elevated and diminished filtration are defined as filtration plus or minus 2 SDs of a nondiabetic lean group with a peripheral fat distribution and UAE of 0 to 15 mg/24 h, corrected for age and sex. The total population was divided into six groups according to body weight (overweight is defined as body mass index [BMI] > 25 and less than or equal to 30 kg/m(2); obesity, as BMI > 30 kg/m(2)) and fat distribution. Results: In logistic regression analysis, obese subjects with central fat distribution had a greater risk for microalbuminuria (relative risk, 1.7; 95% confidence interval, 1.19 to 2.35). Obese subjects with either peripheral or central fat distribution had a greater risk for elevated filtration (relative risk, 3.2; 95% confidence interval, 1.19 to 8.47; relative risk, 2.6; 95% confidence interval, 1.59 to 4.28, respectively). Furthermore, subjects with central fat distribution, either lean, overweight, or obese, had a greater risk for diminished filtration (relative risk, 1.9; 95% confidence interval, 1.19 to 3.12; relative risk, 2.0; 95% confidence interval, 1.19 to 3.19; and relative risk, 2.7; 95% confidence interval, 1.46 to 4.85, respectively). Finally, by dividing waist-hip ratio (WHR) into quartiles, greater WHR was associated with a greater risk for diminished filtration, even when corrected for BMI. Conclusion: Not only overweight and obese subjects, but also lean subjects with central fat distribution are at risk for diminished filtration. Therefore, a central pattern of fat distribution, not overweight or obesity by itself, seems to be important for renal impairment. (C) 2003 by the National Kidney Foundation, Inc.