PREVALENCE OF PROTEINURIA IN OVERWEIGHT ADOLESCENTS

超重青少年中蛋白尿的患病率

• 批准号: 8167347
• 负责人: Mona Khurana
• 金额: $ 8.81万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-20 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8167347
• 关键词: Academy; Adolescent; Adult; Age; American; Animals; Autopsy; Body mass index; Case Series; Case Study; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Chronic; Clinical; Comorbidity; Computer Retrieval of Information on Scientific Projects Database; Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Diet; Early Diagnosis; End stage renal failure; Enrollment; Epidemic; Excretory function; Experimental Models; Funding; Grant; Health; Height; High Prevalence; Hypertension; Injury; Institution; Kidney; Kidney Diseases; Link; Measurement; Medical center; Obesity; Overweight; Participant; Pathologic; Pediatrics; Population; Population Study; Prevalence; Prevention Guidelines; Prospective Studies; Proteins; Proteinuria; Race; Renal function; Reporting; Research; Research Personnel; Resources; Risk Factors; Sampling; Screening procedure; Series; Source; Time; United States; United States National Institutes of Health; Urinalysis; Urine; Weight; design; obesity in children; sex

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The prevalence of obesity in the United States has steadily increased in both adults and children over the past three decades and has currently reached epidemic proportions in both sexes and all racial groups [1-4]. The association between chronic obesity and the subsequent development of hypertension and diabetes mellitus type ii is well established in adults [5]. These obesity-related co-morbidities are currently the leading two causes of end stage renal disease (ESRD) in the adult population. Despite these links to ESRD, obesity is not traditionally identified as a risk factor for renal disease, and its direct effects on renal function are not well understood. Proteinuria was first reported in obese adults over thirty years ago [35]. Subsequent case reports [24, 35, 36], case series [24, 37], and autopsy series [10, 25] have further described associations between proteinuria and obesity. Growing data suggests that proteinuria is not only a marker of renal disease but is also an effector of renal injury. This is supported by a number of experimental models of diet-induced obesity in animals which demonstrate proteinuria as well as renal functional and structural adaptations in glomeruli and the tubulointerstitium. Multiple prospective studies have recently demonstrated that proteinuria is a strong, independent predictor of progression of chronic glomerulopathies [29-33]. Furthermore, the rate of decline in renal function and progression to ESRD significantly decrease with amelioration in proteinuria [34], suggesting that early detection of proteinuria and its amelioration can help preserve renal function for a longer period of time. The clinical implications of this are manifold as current screening practices for proteinuria rely on infrequent urine dipstick analysis. Despite the growing epidemic of childhood obesity, the American Academy of Pediatrics currently recommends screening urinalyses only twice in childhood [26], making it difficult to establish the true prevalence of proteinuria in the obese U.S. pediatric population. Only one study has examined the difference in urine protein excretion between obese children versus lean counterparts [38]. While this study demonstrated a higher level of proteinuria in the obese group versus the lean group, no prevalence data was reported. To date, there has been no large scale, systematic study examining the prevalence of proteinuria in obese children and adolescents. ?? ?? The overall objective of this study is to determine whether there is an association between increased body mass index and proteinuria. We hypothesize that the prevalence of pathologic proteinuria will be higher in overweight adolescents when compared with lean adolescents. The aim of the study is to determine the prevalence of pathologic proteinuria in overweight adolescents. This is a cross-sectional study pilot designed to determine the prevalence of pathologic proteinuria in overweight adolescents, ages 12 to 21 years, seen in the Adolescent Health Center which are affiliated with Children's National Medical Center. Upon study enrollment, each participant will undergo standardized height and weight measurements. The participant's body mass index (BMI) will be calculated and BMI percentile for sex and age will be determined using the Centers for Disease Control and Prevention guidelines. Those participants with a BMI 95th percentile for sex and age will be categorized as overweight. A minimum of one and maximum of two urine samples will be collected per participant for the duration of the study. The first urine sample will be obtained at the time of recruitment. Comparisons will be made between values obtained from lean versus overweight adolescents to determine whether there is a higher prevalence of pathologic proteinuria in the study population.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 在过去的三十年中，美国和儿童的肥胖症患病率在美国稳步增长，目前在性别和所有种族群体中都达到了流行的比例[1-4]。慢性肥胖与高血压和糖尿病II型糖尿病的随后发展之间的关联已在成人中得到很好的建立[5]。这些与肥胖相关的合并症目前是成人人群中终末期肾脏疾病（ESRD）的主要两个原因。尽管有这些与ESRD的联系，但传统上并未将肥胖症视为肾脏疾病的危险因素，并且对肾功能的直接影响尚不清楚。 蛋白尿首次在三十年前的肥胖成年人中报道[35]。随后的病例报告[24，35，36]，病例序列[24，37]和尸检系列[10，25]进一步描述了蛋白尿和肥胖之间的关联。不断增长的数据表明，蛋白尿不仅是肾脏疾病的标记，而且还是肾损伤的效应因子。这得到了动物饮食诱导的肥胖的许多实验模型的支持，这些模型表现出肾小球和肾小球的肾功能和结构适应性。多项前瞻性研究最近表明蛋白尿是慢性肾小球病的进展的强大，独立的预测指标[29-33]。此外，随着蛋白尿的改善，肾功能的下降和向ESRD的进展显着降低[34]，这表明蛋白尿及其改善的早期检测可以帮助保留更长的时间。由于蛋白尿的当前筛查实践依赖于尿液量强壮的分析，因此临床的含义是多种多样的。尽管儿童肥胖的流行日益增长，但美国儿科学院目前建议在儿童期仅两次筛查尿液线[26]，因此很难在肥胖的美国儿科人群中确定蛋白尿的真正患病率。只有一项研究检查了肥胖儿童与瘦同伴之间的尿蛋白排泄差异[38]。尽管这项研究表明肥胖组与瘦肉组的蛋白尿水平更高，但没有报告患病率数据。迄今为止，还没有大规模的系统研究研究肥胖儿童和青少年蛋白尿的患病率。 ？ ？ 这项研究的总体目的是确定体重指数增加和蛋白尿之间是否存在关联。我们假设与瘦青少年相比，超重青少年的病理蛋白尿的患病率将更高。该研究的目的是确定超重青少年病理蛋白尿的患病率。 这是一项横断面研究试验，旨在确定超重青少年的病理蛋白尿的患病率，年龄在12至21岁之间，在青少年健康中心可见，该中心隶属于儿童国家医疗中心。在研究入学时，每个参与者将接受标准化的身高和体重测量。将计算参与者的体重指数（BMI），性别和年龄的BMI百分比将使用疾病控制和预防指南中心确定。那些具有BMI第95个百分点的性别和年龄的参与者将被归类为超重。在研究期间，每个参与者将收集至少一个和最多两个尿液样本。第一个尿液样本将在招募时获得。将在研究人群中从瘦肉与超重青少年获得的值之间进行比较，以确定病理蛋白尿的患病率更高。