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中年日本男性内脏脂肪蓄积与尿白蛋白肌酐比值的关系。

Relationship between visceral fat accumulation and urinary albumin-creatinine ratio in middle-aged Japanese men.

机构信息

Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, 2-2 B-5, Yamada-oka, Suita, Osaka 565-0871, Japan.

出版信息

Atherosclerosis. 2010 Aug;211(2):601-5. doi: 10.1016/j.atherosclerosis.2010.02.037. Epub 2010 Mar 4.

Abstract

OBJECTIVE

Chronic kidney disease including microalbuminuria relates to cardiovascular disease (CVD). Microalbuminuria is also known to be a marker of generalized endothelial dysfunction. The metabolic syndrome which encompasses visceral fat accumulation and various metabolic disorders, has also an increase in albuminuria and relates to CVD. However, the relationship between visceral fat accumulation and albuminuria remains to be defined. The present study investigated the relationship between visceral fat accumulation and urinary albumin-creatinine ratio (UACR) in Japanese men.

METHODS

This study group comprised 1990 Japanese male subjects, who were employees of a city office, had undergone annual health check-up. Urinary albumin was collected from a single spot urine specimen collected anytime between morning and afternoon. Visceral fat area was estimated (eVFA) by the bioelectrical impedance analysis method.

RESULTS

Log-UACR correlated with age, log-body mass index (BMI), log-waist circumference (WC), log-eVFA, log-adiponectin, blood pressure, serum lipids and hemoglobin A1c (HbA1c). Stepwise multiple regression analysis identified log-eVFA, as well as HbA1c, blood pressure, log-TG, and age, as a significant determinant of log-UACR. Moreover, subjects with eVFA > or = 100 cm(2) had significantly higher UACR than those with eVFA <100 cm(2), irrespective of BMI. UACR was significantly worse in subjects with high numbers of metabolic risk factors, and moreover in subjects with eVFA > or = 100 cm(2) than in those with eVFA <100 cm(2).

CONCLUSION

These results suggested that visceral fat accumulation is associated with an increase in UACR. Evaluation of both visceral fat accumulation and urinary albumin may be important for preventing atherosclerotic diseases.

摘要

目的

慢性肾脏病包括微量白蛋白尿与心血管疾病(CVD)有关。微量白蛋白尿也被认为是全身内皮功能障碍的标志物。代谢综合征包括内脏脂肪堆积和各种代谢紊乱,也会导致白蛋白尿增加,并与 CVD 相关。然而,内脏脂肪堆积与白蛋白尿之间的关系仍有待确定。本研究旨在探讨日本男性内脏脂肪堆积与尿白蛋白肌酐比(UACR)之间的关系。

方法

本研究组包括 1990 名日本男性,他们是一个城市办公室的员工,每年都要进行健康检查。尿白蛋白取自上午至下午之间任意时间采集的单次尿样。通过生物电阻抗分析方法估算内脏脂肪面积(eVFA)。

结果

log-UACR 与年龄、log 体重指数(BMI)、log 腰围(WC)、log-eVFA、log-脂联素、血压、血脂和血红蛋白 A1c(HbA1c)相关。逐步多元回归分析确定 log-eVFA 以及 HbA1c、血压、log-TG 和年龄是 log-UACR 的重要决定因素。此外,eVFA≥100cm²的受试者的 UACR 明显高于 eVFA<100cm²的受试者,无论 BMI 如何。UACR 在代谢风险因素较多的受试者中明显较差,而且在 eVFA≥100cm²的受试者中比在 eVFA<100cm²的受试者中更差。

结论

这些结果表明,内脏脂肪堆积与 UACR 增加有关。评估内脏脂肪堆积和尿白蛋白可能对预防动脉粥样硬化性疾病很重要。

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