Okada R, Yasuda Y, Tsushita K, Wakai K, Hamajima N, Matsuo S
Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nutr Metab Cardiovasc Dis. 2014 Mar;24(3):277-85. doi: 10.1016/j.numecd.2013.08.004. Epub 2013 Oct 9.
Renal hyperfiltration (early-stage kidney damage) and hypofiltration (late-stage kidney damage) are common in populations at high risk of chronic kidney disease. This study investigated the associations of renal hyperfiltration and hypofiltration with the number of metabolic syndrome (MetS) components.
The study subjects included 205,382 people aged 40-74 years who underwent Specific Health Checkups in Aichi Prefecture, Japan. The prevalence of renal hyperfiltration [estimated glomerular filtration rate (eGFR) above the age-/sex-specific 95th percentile] and hypofiltration (eGFR below the 5th percentile) was compared according to the number of MetS components. We found that the prevalence of both hyperfiltration and hypofiltration increased with increasing number of MetS components (odds ratios for hyperfiltration: 1.20, 1.40, 1.42, 1.41, and 1.77; odds ratios for hypofiltration: 1.07, 1.25, 1.57, 1.89, and 2.21 for one, two, three, four, and five components, respectively, compared with no MetS components). These associations were observed in both normal weight [body mass index (BMI) < 25 kg/m(2)] and overweight (BMI ≥ 25 kg/m(2)) subjects. Renal hyperfiltration was associated with prehypertension and prediabetes, while hypofiltration was associated with dyslipidemia, abdominal obesity, overt hypertension, and overt diabetes.
The number of MetS components is a good risk indicator of early- and late-stage kidney damage. Therefore, kidney function should be monitored in subjects with MetS components. MetS components should be treated as early as possible to prevent the development of kidney damage and cardiovascular diseases in people with hyperfiltration, regardless of their body weight.
肾高滤过（早期肾脏损伤）和低滤过（晚期肾脏损伤）在慢性肾脏病高危人群中很常见。本研究调查了肾高滤过和低滤过与代谢综合征（MetS）组分数量之间的关联。
研究对象包括205,382名年龄在40 - 74岁之间、在日本爱知县接受特定健康检查的人群。根据MetS组分数量比较了肾高滤过[估计肾小球滤过率（eGFR）高于年龄/性别特异性第95百分位数]和低滤过（eGFR低于第5百分位数）的患病率。我们发现，高滤过和低滤过的患病率均随MetS组分数量的增加而升高（与无MetS组分相比，高滤过的优势比分别为1.20、1.40、1.42、1.41和1.77；低滤过的优势比分别为1.07、1.25、1.57、1.89和2.21，对应一、二、三、四和五个组分）。在正常体重[体重指数（BMI）< 25 kg/m²]和超重（BMI≥25 kg/m²）受试者中均观察到这些关联。肾高滤过与高血压前期和糖尿病前期相关，而低滤过与血脂异常、腹型肥胖、显性高血压和显性糖尿病相关。
MetS组分数量是早期和晚期肾脏损伤的良好风险指标。因此，应对有MetS组分的受试者进行肾功能监测。无论体重如何，对于高滤过人群，应尽早治疗MetS组分以预防肾脏损伤和心血管疾病的发生。
