Ferris Maria, Hogan Susan L, Chin Hyunsook, Shoham David A, Gipson Debbie S, Gibson Keisha, Yilmaz Sema, Falk Ronald J, Jennette J Charles
UNC Kidney Center and Division of Nephrology & Hypertension, CB #7155, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7156, USA.
Clin J Am Soc Nephrol. 2007 Nov;2(6):1207-14. doi: 10.2215/CJN.00540107. Epub 2007 Oct 17.
Obesity has been associated with kidney disease in adults. This study was designed to evaluate the association of obesity with an early marker of kidney disease, albuminuria, among young adults.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Urinalysis (n = 9371), albumin-to-creatinine ratio (n = 4463), and body mass index (kg/m2) were measured in the Add Health Wave III cohort (2001 to 2002), a multiethnic sample of young adults followed for approximately 6 yr. Multivariate logistic regression modeled the association of sex-specific albuminuria with body mass index, adjusted for sample weights, sex, race, ethnicity, and glycosuria.
Urinalysis revealed that 0.8% had proteinuria, 4.6% had hematuria, 0.2% had combined hematuria and proteinuria, and 1.5% had glycosuria. Albuminuria prevalence was 4.4%. Mean body mass index was higher among those with albuminuria compared with those without. There were no associations between body mass index categories of 25 to < 30 or 30 to < 35 kg/m2 with albuminuria compared with the lowest body mass index (< 25 kg/m2); however, the highest category (> or = 35 kg/m2) was associated with albuminuria, compared with the lowest category (OR = 1.76, 95% CI: 1.02 to 3.04). Glycosuria (OR = 4.0; 95% CI: 1.5 to 11.1, p < 0.01) as well as increasing body mass index during the 6-yr follow-up (OR: 1.07 per unit change in kg/m2; 95% CI: 1.00 to 1.13, p = 0.04) were also associated with albuminuria.
Given the increasing prevalence of obesity, the association of albuminuria associated with obesity in young adults is particularly concerning. Obesity may be a target for primary prevention of kidney and cardiovascular disease.
肥胖与成人肾脏疾病相关。本研究旨在评估肥胖与年轻成人肾脏疾病早期标志物蛋白尿之间的关联。
设计、地点、参与者及测量方法:在“青少年健康纵向研究”第三波队列研究(2001年至2002年)中,对9371名参与者进行了尿液分析,对4463名参与者测量了白蛋白与肌酐比值,并测量了体重指数(kg/m²)。该队列研究是一个多民族年轻成人样本,随访约6年。多变量逻辑回归模型分析了按性别分类的蛋白尿与体重指数之间的关联,并对样本权重、性别、种族、民族和糖尿进行了校正。
尿液分析显示,0.8%的人有蛋白尿,4.6%的人有血尿,0.2%的人同时有血尿和蛋白尿,1.5%的人有糖尿。蛋白尿患病率为4.4%。有蛋白尿者的平均体重指数高于无蛋白尿者。与最低体重指数组(<25 kg/m²)相比,体重指数在25至<30 kg/m²或30至<35 kg/m²组与蛋白尿无关联;然而,与最低组相比,最高组(≥35 kg/m²)与蛋白尿相关(比值比=1.76,95%置信区间:1.02至3.04)。糖尿(比值比=4.0;95%置信区间:1.5至11.1,p<0.01)以及在6年随访期间体重指数增加(每单位kg/m²变化的比值比:1.07;95%置信区间:1.00至1.13,p=0.04)也与蛋白尿相关。
鉴于肥胖患病率不断上升,年轻成人中肥胖与蛋白尿的关联尤其令人担忧。肥胖可能是肾脏疾病和心血管疾病一级预防的目标。