Nutrition and Diabetes Department, Hospital Durand, Buenos Aires, Argentina.
Pediatr Diabetes. 2010 Aug;11(5):322-30. doi: 10.1111/j.1399-5448.2009.00599.x.
Different studies in adults have shown that obesity is an independent risk factor for end-stage renal disease.
It was to (i) determine the association between albuminuria and age, gender, BMI, waist circumference (WC), and blood pressure (ii) relate albuminuria to gender and age in healthy school children.
Over 1564 students (806 males) aged 9.35 +/- 2.00 yr from 9 elementary schools in Buenos Aires, were examined between April and September 2005. BMI, WC, blood pressure, urinary albumin excretion and albumin/creatinine ratio (ACR) were determined.
Over 220 (14.1%) children were obese (OB), and 300 (19.2%) overweight (OW) using centers for disease control (CDC) norms. Median ACR and urinary albumin levels were higher in normal weight children than in OW/OB children (p < 0.01). Median values for ACR were higher in girls than in boys (p < 0.001). OW/OB proved to be a protective factor against ACR [OR, 0.77 (95% CI 0.64-0.92)], whereas female gender [OR, 2.72 (95% CI 2.13-3.47)] was associated with a higher ACR adjusted for age systolic and diastolic blood pressure in the multiple logistic regression analysis. Therefore, children with OW/OB had 23% lower odds of having ACR >or= III quartile and girls had more than two and half times the risk of having high ACR.
Our results suggest that OW/OB is inversely associated with childhood albuminuria while female gender is positively associated. Whether the results can be explained by the increased physical activity in lean children should be the subject of future investigations. These results suggest that micro-albuminuria in children may not be a useful tool in the early identification of children at risk for future renal and cardiovascular disease (CVD).
不同的成年人研究表明,肥胖是终末期肾病的独立危险因素。
(i)确定蛋白尿与年龄、性别、BMI、腰围(WC)和血压之间的关系;(ii)在健康的学龄儿童中,将蛋白尿与性别和年龄联系起来。
2005 年 4 月至 9 月,在布宜诺斯艾利斯的 9 所小学对 1564 名学生(806 名男性)进行了检查,年龄为 9.35 +/- 2.00 岁。测定 BMI、WC、血压、尿白蛋白排泄和白蛋白/肌酐比值(ACR)。
根据疾病控制中心(CDC)的标准,超过 220 名(14.1%)儿童肥胖(OB),300 名(19.2%)超重(OW)。与 OW/OB 儿童相比,正常体重儿童的 ACR 和尿白蛋白水平更高(p < 0.01)。女孩的 ACR 中位数高于男孩(p < 0.001)。OW/OB 是 ACR 的保护因素[比值比(OR),0.77(95%可信区间,0.64-0.92)],而女性性别[OR,2.72(95%可信区间,2.13-3.47)]在多变量逻辑回归分析中与年龄、收缩压和舒张压调整后的 ACR 相关。因此,OW/OB 儿童发生 ACR >or= 第三四分位数的几率降低 23%,女孩发生高 ACR 的风险增加 2.5 倍以上。
我们的结果表明,OW/OB 与儿童蛋白尿呈负相关,而女性性别呈正相关。在瘦儿童中增加体力活动是否可以解释这些结果,应该是未来研究的主题。这些结果表明,儿童微量白蛋白尿可能不是早期识别未来肾脏和心血管疾病(CVD)风险儿童的有用工具。