Ding Wei, Mak Robert H
Division of Pediatric Nephrology, University of California, 9500 Gilman Drive, Mailcode 0634, La Jolla, CA, 92093, USA.
Pediatr Nephrol. 2015 Jan;30(1):1-4. doi: 10.1007/s00467-014-2976-3. Epub 2014 Oct 17.
Childhood obesity has become a global epidemic. Recent epidemiological data suggest that obesity is associated with increased risk of renal injury in children. The onset of obesity-associated renal disease is insidious and asymptomatic, so early markers will be extremely useful in its prevention and treatment. Biomarker discovery can be focused on unbiased or biased (candidate) approaches. Unbiased approaches using innovative technologies, such as proteomics and metabolomics, have uncovered candidates that are emerging as plausible biomarkers for such renal disorders as obstructive uropathy and diabetic nephropathy. Biased approaches are based on hypotheses related to glomerular or tubular injury pathophysiology in obesity. Goknar et al. (Pediatric Nephrology 2014; doi: 10.1007/s00467-014-2829-0 ) recently evaluated early urine renal injury markers, namely, microalbuminuria, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and kidney injury molecule (KIM)-1, in obese children. They reported that obese children had higher urinary NAG and KIM-1 levels than healthy controls. Longitudinal observation studies are needed to evaluate whether these tubular damage markers are useful as early markers of renal injury in obese children.
儿童肥胖已成为一种全球流行病。最近的流行病学数据表明，肥胖与儿童肾损伤风险增加有关。肥胖相关肾病的发病隐匿且无症状，因此早期标志物对其预防和治疗极为有用。生物标志物的发现可聚焦于无偏倚或有偏倚（候选）方法。使用蛋白质组学和代谢组学等创新技术的无偏倚方法已发现一些候选物，这些候选物正成为诸如梗阻性肾病和糖尿病肾病等肾脏疾病看似合理的生物标志物。有偏倚方法基于与肥胖中肾小球或肾小管损伤病理生理学相关的假设。Goknar等人（《儿科肾病学》2014年；doi:10.1007/s00467-014-2829-0）最近评估了肥胖儿童早期尿肾损伤标志物，即微量白蛋白尿、N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子（KIM）-1。他们报告称，肥胖儿童的尿NAG和KIM-1水平高于健康对照。需要进行纵向观察研究，以评估这些肾小管损伤标志物是否可作为肥胖儿童肾损伤的早期标志物。
