Matsushita Kei, Yasuda Gen, Shouda Masataka, Umemura Satoshi
Seamen's Insurance Health Care and Research Center, 43-2 Kamadai, Hodogaya-ku, Yokohama, 240-0066, Japan.
Division of Nephrology, Yokohama City University School of Medicine, Yokohama, Japan.
Clin Exp Nephrol. 2009 Aug;13(4):316-324. doi: 10.1007/s10157-009-0164-8. Epub 2009 Apr 18.
Although obesity is recognized to be a risk factor for chronic kidney disease (CKD), few studies have reported the association between obesity and CKD in the young population. We investigated the relationship between obesity and renal function including proteinuria in young Japanese.
This cross-sectional study consisted of 16,031 men and 5,746 women aged from 20 to 39 years who received health examinations. The subjects were stratified into four age groups (20-24, 25-29, 30-34, and 35-39 years) or into four groups based on the number of risk factors (hypertension, hyperglycemia, dyslipidemia, and hyperuricemia). The relationship between obesity and risk factors and the relationship between obesity and estimated glomerular filtration rate (eGFR) were analyzed.
There were no significant differences in eGFR between obese and nonobese groups, except in the male 35-39 years age group. Body mass index (BMI) in both men and women increased with increase in number of risk factors (P < 0.001). Multivariate analysis revealed that hypertension, hyperglycemia, dyslipidemia, and hyperuricemia were independently associated with obesity. Obesity and the risk factors were independently associated with proteinuria.
The present study indicated that obesity was an independent risk factor for proteinuria in healthy subjects younger than 40 years of age. The other risk factors were independently associated with obesity. These findings suggest that obesity causes proteinuria concomitantly with other risk factors such as hypertension, diabetes, and dyslipidemia in young adults.
尽管肥胖被认为是慢性肾脏病（CKD）的一个危险因素，但很少有研究报道肥胖与年轻人群CKD之间的关联。我们调查了日本年轻人中肥胖与包括蛋白尿在内的肾功能之间的关系。
这项横断面研究纳入了16031名男性和5746名年龄在20至39岁之间接受健康检查的女性。受试者被分为四个年龄组（20 - 24岁、25 - 29岁、30 - 34岁和35 - 39岁）或根据危险因素（高血压、高血糖、血脂异常和高尿酸血症）的数量分为四组。分析了肥胖与危险因素之间的关系以及肥胖与估计肾小球滤过率（eGFR）之间的关系。
除了35 - 39岁男性年龄组外，肥胖组和非肥胖组的eGFR没有显著差异。男性和女性的体重指数（BMI）均随着危险因素数量的增加而升高（P < 0.001）。多变量分析显示，高血压、高血糖、血脂异常和高尿酸血症与肥胖独立相关。肥胖和危险因素与蛋白尿独立相关。
本研究表明，肥胖是40岁以下健康受试者蛋白尿的独立危险因素。其他危险因素与肥胖独立相关。这些发现表明，在年轻人中，肥胖与高血压、糖尿病和血脂异常等其他危险因素一起导致蛋白尿。
