Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Nephrol Dial Transplant. 2014 Nov;29(11):2106-13. doi: 10.1093/ndt/gfu221. Epub 2014 Jun 18.
There are limited data on the association between underweight and albuminuria. The aim of this study is to verify the effect of underweight on the development of albuminuria.
Participants who underwent two health check-ups with a 2-year interval at a tertiary hospital in Korea between 2002 and 2009 were studied. After exclusion of participants with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) or dipstick albuminuria ≥1+ at the first check-up, 53 876 participants were enrolled. We measured the incidence of albuminuria at the second check-up and calculated the odds ratio (OR) for the development of albuminuria according to body mass index (BMI).
After 2 years, 746 cases of incident albuminuria were observed among 53 876 participants. The effect of BMI on the development of albuminuria was modified by sex in a multivariate logistic model with adjustment for age, diabetes, hypertension, dyslipidaemia, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, uric acid, eGFR, current smoking status and alcohol intake (P-value for interaction <0.001). Compared with participants in the normal weight range (BMI, 18.5-22.9), the ORs for incident albuminuria were 1.93 [95% confidence interval (CI), 1.35-2.76; P ≤ 0.001], 1.19 (0.84-1.67; P = 0.329) and 0.71 (0.43-1.17; P = 0.177) in underweight (BMI, <18.5), overweight (BMI, 23.0-24.9) and obese (BMI, ≥25) women. However, the ORs were 0.9 (95% CI, 0.39-2.05; P = 0.794), 1.08 (0.84-1.38; P = 0.567) and 1.38 (1.09-1.75; P = 0.007) for each corresponding group of men.
Underweight was significantly associated with the development of albuminuria after 2 years in relatively healthy Korean females, but this relationship was not significant in males. This study suggests the need for more studies on the role of underweight in renal injury in men and women.
目前关于体重过轻与白蛋白尿之间关联的相关数据有限。本研究旨在验证体重过轻对白蛋白尿发生的影响。
研究对象为 2002 年至 2009 年间在韩国一家三级医院接受了两次健康检查且两次检查间隔为 2 年的人群。排除第一次检查时估算肾小球滤过率（eGFR）＜60 mL/min/1.73 m²或尿试纸白蛋白尿≥1+的参与者后，共纳入 53876 名参与者。我们测量了第二次检查时的白蛋白尿发生率，并根据体重指数（BMI）计算了白蛋白尿发生的优势比（OR）。
在 53876 名参与者中，经过 2 年随访，有 746 例发生了白蛋白尿事件。在多变量逻辑模型中，当按性别调整年龄、糖尿病、高血压、血脂异常、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸、eGFR、当前吸烟状况和饮酒量后（交互作用 P 值＜0.001），BMI 对白蛋白尿发生的影响具有性别差异。与正常体重范围（BMI，18.5-22.9）的参与者相比，体重过轻（BMI＜18.5）、超重（BMI，23.0-24.9）和肥胖（BMI≥25）女性发生白蛋白尿事件的 OR 分别为 1.93（95%CI，1.35-2.76；P≤0.001）、1.19（0.84-1.67；P=0.329）和 0.71（0.43-1.17；P=0.177）。然而，相应男性组的 OR 分别为 0.9（95%CI，0.39-2.05；P=0.794）、1.08（0.84-1.38；P=0.567）和 1.38（1.09-1.75；P=0.007）。
在相对健康的韩国女性中，体重过轻与 2 年后白蛋白尿的发生显著相关，但在男性中这种相关性并不显著。本研究提示需要更多研究来探究男性和女性中体重过轻在肾脏损伤中的作用。
