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超声评估肾周和肾旁脂肪厚度是肥胖患者早期肾脏损害的独立预测因子。

Sonographic evaluation of para- and perirenal fat thickness is an independent predictor of early kidney damage in obese patients.

机构信息

Department of Endocrinology, Affiliated Hospital of Weifang Medical University, No.2428, Yuhe Road, Weifang, 261031, Shandong, China,

出版信息

Int Urol Nephrol. 2013 Dec;45(6):1589-95. doi: 10.1007/s11255-013-0404-4. Epub 2013 Mar 6.

Abstract

PURPOSE

To determine whether para- and perirenal fat ultrasonographic thickness (PFUT) is related to increased urinary albumin excretion and whether PFUT is an independent indicator of early kidney damage in obese subjects.

METHOD

Sixty-seven nonhypertensive, nondiabetic obese patients and 34 age- and sex-matched normal healthy volunteers were involved in this study. Clinical characteristics, blood biochemistry, PFUT, and urinary albumin/creatinine ratio (ACR) of the subjects were measured. The intraoperator and interoperator coefficient of variation was 5.6 and 3.2 %, respectively.

RESULTS

ACR and PFUT were significantly higher in obese patients than those of normal healthy volunteers. PFUT was higher in obese patients with microalbuminuria than those with normoalbuminuria. Correlation analysis showed PFUT had a positive correlation with body mass index (BMI, r = 0.677, P < 0.01), waist circumference (WC, r = 0.686, P < 0.01), plasma free fatty acids (FFAs, r = 0.589, P < 0.01), and ACR (r = 0.610, P < 0.01). ACR had a positive correlation with BMI (r = 0.444, P < 0.01), WC (r = 0.440, P < 0.01), and plasma FFAs (r = 0.496, P < 0.01). Multivariate regression analyses showed that ACR could be predicted by PFUT.

CONCLUSIONS

PFUT may be an independent predictor of early kidney damage in nonhypertensive, nondiabetic obese patients, and PFUT could be a useful tool for the assessment of visceral fat and early kidney damage in obese patients.

摘要

目的

确定肾周和肾旁脂肪超声厚度(PFUT)是否与尿白蛋白排泄增加有关,以及 PFUT 是否是肥胖患者早期肾脏损害的独立指标。

方法

本研究纳入了 67 名非高血压、非糖尿病的肥胖患者和 34 名年龄和性别匹配的正常健康志愿者。测量了受试者的临床特征、血液生化、PFUT 和尿白蛋白/肌酐比值(ACR)。该方法的内、外操作者变异系数分别为 5.6%和 3.2%。

结果

肥胖患者的 ACR 和 PFUT 明显高于正常健康志愿者。微量白蛋白尿肥胖患者的 PFUT 高于正常白蛋白尿肥胖患者。相关性分析表明,PFUT 与体重指数(BMI,r = 0.677,P < 0.01)、腰围(WC,r = 0.686,P < 0.01)、血浆游离脂肪酸(FFAs,r = 0.589,P < 0.01)和 ACR(r = 0.610,P < 0.01)呈正相关。ACR 与 BMI(r = 0.444,P < 0.01)、WC(r = 0.440,P < 0.01)和血浆 FFAs(r = 0.496,P < 0.01)呈正相关。多元回归分析表明,ACR 可以由 PFUT 预测。

结论

PFUT 可能是非高血压、非糖尿病肥胖患者早期肾脏损害的独立预测指标,PFUT 可能是评估肥胖患者内脏脂肪和早期肾脏损害的有用工具。

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