Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan ; Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan.
Int J Endocrinol. 2013;2013:590569. doi: 10.1155/2013/590569. Epub 2013 Aug 26.
Aims. We analyzed the prevalence of nephropathy according to past body weight status in Japanese subjects with type 2 diabetes because the influence of past obesity on diabetic complications is not certain. Methods. We examined the prevalence of nephropathy in 2927 subjects with type 2 diabetes mellitus according to current BMI and maximum BMI in the past. We defined "current obesity" as BMI on hospitalization of 25 or more, "previous obesity" as BMI on hospitalization of less than 25 and self-reported maximum BMI in the past of 25 or more, and "continuously lean" as maximum BMI of less than 25. Results. The prevalence of nephropathy was significantly higher in subjects with current obesity (40.6%) or previous obesity (35.6%) than in those who were continuously lean (24.3%) (P < 0.017). In logistic regression analysis, previous obesity, as well as current obesity, was a significant risk factor for nephropathy, independent of sex, age, disease duration, hypertension, dyslipidemia, HbA1c, and diabetic retinopathy. Conclusions. Obesity in the past, as well as the present body weight status, was a risk factor for diabetic nephropathy.
目的。我们分析了日本 2 型糖尿病患者过去的体重状况与肾病的相关性,因为过去肥胖对糖尿病并发症的影响尚不确定。方法。我们根据 2927 例 2 型糖尿病患者的当前 BMI 和过去的最大 BMI 分析了肾病的患病率。我们将“当前肥胖”定义为住院时 BMI 为 25 或以上,“既往肥胖”定义为住院时 BMI 低于 25 且自我报告过去的最大 BMI 为 25 或以上,“持续消瘦”定义为最大 BMI 低于 25。结果。与持续消瘦者(24.3%)相比,当前肥胖(40.6%)或既往肥胖(35.6%)患者的肾病患病率显著更高(P<0.017)。在逻辑回归分析中,既往肥胖和当前肥胖均为肾病的独立危险因素,与性别、年龄、病程、高血压、血脂异常、HbA1c 和糖尿病视网膜病变无关。结论。过去的肥胖以及目前的体重状况均是糖尿病肾病的危险因素。