Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Nephron Clin Pract. 2014;126(1):90-6. doi: 10.1159/000360363. Epub 2014 Mar 12.
Previous studies have shown that obesity is a risk factor for estimated glomerular filtration rate (eGFR) decline and chronic kidney disease (CKD). However, the relationship between fat mass directly measured by bioimpedance analysis and eGFR is not well known.
We analyzed 21,859 participants without CKD at baseline who underwent two health checkups at a 5-year interval during 2002-2009. Fat mass was measured by Inbody 3.0 (Biospace, Seoul, Korea). eGFR decline was defined as eGFR <60 ml/min/1.73 m(2) at second checkup. Logistic regression analysis was used to analyze factors related to eGFR decline.
Participants were divided into tertiles according to their fat mass change over 5 years: lower tertile (n = 7,042; <-0.7 kg), middle tertile (n = 7,478; -0.7 to 1.2 kg) and higher tertile (n = 7,339; >1.2 kg). After 5 years, 246 cases of eGFR decline were observed. Multivariate logistic analysis revealed that age (OR 1.03, 95% CI 1.02-1.05, p < 0.001), diabetes mellitus (OR 2.04, 95% CI 1.22-3.40, p = 0.007), baseline eGFR (OR 0.80, 95% CI 0.78-0.83, p < 0.001) and higher tertile of fat mass change (OR 1.58, 95% CI 1.16-2.13, p = 0.003) were associated with eGFR decline after adjustment for sex, hypertension, dyslipidemia, cardiovascular disease, smoking status, body mass index, and high-density lipoprotein cholesterol level.
Fat mass gain over 5 years was independently associated with eGFR decline to <60 ml/min/1.73 m(2) in a relatively healthy Korean population. This finding suggests that lifestyle changes to prevent fat mass gain could be protective against the development of CKD.
先前的研究表明，肥胖是估算肾小球滤过率（eGFR）下降和慢性肾脏病（CKD）的危险因素。然而，直接通过生物阻抗分析测量的脂肪量与 eGFR 之间的关系尚不清楚。
我们分析了 2002-2009 年期间在两次健康检查之间相隔 5 年进行的无 CKD 基线检查的 21859 名参与者。通过 Inbody 3.0（Biospace，首尔，韩国）测量脂肪量。eGFR 下降定义为第二次检查时 eGFR<60ml/min/1.73m2。使用逻辑回归分析来分析与 eGFR 下降相关的因素。
根据他们在 5 年内的脂肪量变化，参与者被分为三分位：低三分位（n=7042；-0.7kg）、中三分位（n=7478；-0.7 至 1.2kg）和高三分位（n=7339；>1.2kg）。5 年后，观察到 246 例 eGFR 下降。多变量逻辑分析显示，年龄（OR 1.03，95%CI 1.02-1.05，p<0.001）、糖尿病（OR 2.04，95%CI 1.22-3.40，p=0.007）、基线 eGFR（OR 0.80，95%CI 0.78-0.83，p<0.001）和脂肪量变化的高三分位（OR 1.58，95%CI 1.16-2.13，p=0.003）与调整性别、高血压、血脂异常、心血管疾病、吸烟状况、体重指数和高密度脂蛋白胆固醇水平后的 eGFR 下降相关。
在相对健康的韩国人群中，5 年内脂肪量增加与 eGFR 下降至<60ml/min/1.73m2 独立相关。这一发现表明，改变生活方式以防止脂肪量增加可能有助于预防 CKD 的发生。
