The University of Texas Southwestern Medical Center Dallas, Dallas, TX 75390-8856, USA.
Am J Kidney Dis. 2010 Nov;56(5):896-906. doi: 10.1053/j.ajkd.2010.05.016.
Few studies have examined the association between obesity and markers of kidney injury in a chronic kidney disease population. We hypothesized that obesity is independently associated with proteinuria, a marker of chronic kidney disease progression.
Observational cross-sectional analysis.
SETTING & PARTICIPANTS: Post hoc analysis of baseline data for 652 participants in the African American Study of Kidney Disease (AASK).
Obesity, determined using body mass index (BMI).
MEASUREMENTS & OUTCOMES: Urine total protein-creatinine ratio and albumin-creatinine ratio measured in 24-hour urine collections.
AASK participants had a mean age of 60.2 ± 10.2 years and serum creatinine level of 2.3 ± 1.5 mg/dL; 61.3% were men. Mean BMI was 31.4 ± 7.0 kg/m(2). Approximately 70% of participants had a daily urine total protein excretion rate <300 mg/d. In linear regression analyses adjusted for sex, each 2-kg/m(2) increase in BMI was associated with a 6.7% (95% CI, 3.2-10.4) and 9.4% (95% CI, 4.9-14.1) increase in urine total protein-creatinine and urine albumin-creatinine ratios, respectively. In multivariable models adjusting for age, sex, systolic blood pressure, serum glucose level, uric acid level, and creatinine level, each 2-kg/m(2) increase in BMI was associated with a 3.5% (95% CI, 0.4-6.7) and 5.6% (95% CI, 1.5-9.9) increase in proteinuria and albuminuria, respectively. The interaction between older age and BMI was statistically significant, indicating that this relationship was driven by younger AASK participants.
May not generalize to other populations; cross-sectional analysis precludes statements regarding causality.
BMI is associated independently with urine total protein and albumin excretion in African Americans with hypertensive nephrosclerosis, particularly in younger patients.
很少有研究在慢性肾脏病患者中检查肥胖与肾脏损伤标志物之间的关系。我们假设肥胖与蛋白尿独立相关，蛋白尿是慢性肾脏病进展的标志物。
非洲裔美国人肾脏病研究（AASK）的基线数据的事后分析。
AASK 中 652 名参与者的基线数据的事后分析。
肥胖，用体重指数（BMI）来衡量。
24 小时尿液收集物中测量的尿总蛋白-肌酐比和白蛋白-肌酐比。
AASK 参与者的平均年龄为 60.2 ± 10.2 岁，血清肌酐水平为 2.3 ± 1.5mg/dL；61.3%为男性。平均 BMI 为 31.4 ± 7.0kg/m²。约 70%的参与者每日尿总蛋白排泄率<300mg/d。在调整性别后的线性回归分析中，BMI 每增加 2kg/m²，尿总蛋白-肌酐比和尿白蛋白-肌酐比分别增加 6.7%（95%CI，3.2-10.4）和 9.4%（95%CI，4.9-14.1）。在调整年龄、性别、收缩压、血糖水平、尿酸水平和肌酐水平的多变量模型中，BMI 每增加 2kg/m²，蛋白尿和白蛋白尿分别增加 3.5%（95%CI，0.4-6.7）和 5.6%（95%CI，1.5-9.9）。年龄与 BMI 之间的交互作用具有统计学意义，表明这种关系是由年轻的 AASK 参与者驱动的。
可能不适用于其他人群；横断面分析不允许就因果关系发表声明。
BMI 与高血压性肾硬化症的非裔美国人尿总蛋白和白蛋白排泄独立相关，尤其是在年轻患者中。
