Sabanayagam Charumathi, Wong Tien Yin, Liao Jiemin, Sethi Sunil, Teo Boon Wee
Singapore Eye Research Institute, 11 Third Hospital Avenue, #06-13, SNEC Bldg, Singapore, 168751, Singapore,
Clin Exp Nephrol. 2014 Dec;18(6):919-24. doi: 10.1007/s10157-014-0945-6. Epub 2014 Feb 14.
Obesity is associated with diabetes and hypertension, two major risk factors for chronic kidney disease (CKD). Recently, it has been shown that obesity is associated with preclinical kidney disease defined by elevated levels of cystatin C among those without CKD in US adults. However, the association of obesity with cystatin C is not known in industrialized Asian populations.
We examined 2,052 Indian adults aged 40-80 years in Singapore who were free of CKD defined as a serum creatinine-based estimated glomerular filtration rate (eGFRcr) <60 mL/min/1.73 m(2) and/or the presence of microalbuminuria. Body mass index (BMI) values were categorized into normal (18.5-24.9), overweight (25-29.9) and obese (≥30 kg/m(2)). Elevated serum cystatin C was defined as cystatin C ≥1 mg/L.
Overweight and obesity were significantly associated with elevated levels of cystatin C after adjusting for potential confounders including diabetes and hypertension and eGFRcr. Compared to those with normal weight, the odds ratio (95 % confidence interval) of elevated cystatin C was 1.49 (1.17-1.88) for overweight and 3.20 (2.33-4.39) for obese. This association was consistently present when BMI was analyzed as a continuous variable and also in subgroups of men, women and in those without diabetes mellitus or hypertension.
Higher BMI levels are associated with preclinical kidney disease in Indian adults aged 40 years and above without CKD.
肥胖与糖尿病和高血压相关，这是慢性肾脏病（CKD）的两个主要危险因素。最近有研究表明，在美国成年人中，肥胖与无CKD人群中胱抑素C水平升高所定义的临床前期肾脏疾病相关。然而，在工业化亚洲人群中，肥胖与胱抑素C的关联尚不清楚。
我们对新加坡2052名年龄在40 - 80岁的印度成年人进行了研究，这些人无CKD，CKD定义为基于血清肌酐的估计肾小球滤过率（eGFRcr）<60 mL/min/1.73 m²和/或存在微量白蛋白尿。体重指数（BMI）值分为正常（18.5 - 24.9）、超重（25 - 29.9）和肥胖（≥30 kg/m²）。血清胱抑素C升高定义为胱抑素C≥1 mg/L。
在调整包括糖尿病、高血压和eGFRcr等潜在混杂因素后，超重和肥胖与胱抑素C水平升高显著相关。与体重正常者相比，超重者胱抑素C升高的比值比（95%置信区间）为（1.17 - 1.88）1.49，肥胖者为（2.33 - 4.39）3.20。当将BMI作为连续变量分析时，以及在男性、女性亚组以及无糖尿病或高血压的人群中，这种关联均持续存在。
在40岁及以上无CKD的印度成年人中，较高的BMI水平与临床前期肾脏疾病相关。
