Xiao Nianzhou, Jenkins Todd M, Nehus Edward, Inge Thomas H, Michalsky Marc P, Harmon Carroll M, Helmrath Michael A, Brandt Mary L, Courcoulas Anita, Moxey-Mims Marva, Mitsnefes Mark M
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Obesity (Silver Spring). 2014 Nov;22(11):2319-25. doi: 10.1002/oby.20870.
Determine objective measures of kidney function and analyze factors associated with kidney dysfunction in severely obese adolescents undergoing weight loss surgery were described.
Cross-sectional data from 242 adolescent participants in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study before weight loss surgery were analyzed. Kidney status was assessed by measuring urine albumin creatinine ratio to determine microalbuminuria and by calculating serum cystatin C-based estimated glomerular filtration rate (eGFR) to assess kidney function.
Mean age and median body mass index (BMI) were 17.1 years and 50.5 kg/m(2) , respectively; 76% were females and 65% were non-Hispanic white race. Fourteen percent of the cohort had microalbuminuria, and 3% had macroalbuminuria; 3% had eGFR < 60 ml/min/1.73 m(2) , and 7.1% had eGFR > 150 ml/min/1.73 m(2) . In adjusted analyses, female gender and increasing ferritin levels were significantly associated with the presence of microalbuminuria/macroalbuminuria. Increasing BMI and homeostasis model assessment of insulin resistance values were significantly associated with lower eGFR.
A significant number of severely obese adolescents undergoing weight loss surgery have evidence of early kidney dysfunction. Longitudinal studies following weight loss surgery in these individuals are needed to determine whether these kidney abnormalities are reversible following weight loss therapy.
描述在接受减肥手术的严重肥胖青少年中确定肾功能的客观指标，并分析与肾功能障碍相关的因素。
分析了来自青少年减肥手术纵向评估（Teen-LABS）研究中242名青少年参与者在减肥手术前的横断面数据。通过测量尿白蛋白肌酐比值以确定微量白蛋白尿，并通过计算基于血清胱抑素C的估计肾小球滤过率（eGFR）来评估肾脏状况，从而评估肾功能。
平均年龄和中位体重指数（BMI）分别为17.1岁和50.5kg/m²；76%为女性，65%为非西班牙裔白人。该队列中14%有微量白蛋白尿，3%有大量白蛋白尿；3%的估计肾小球滤过率（eGFR）<60ml/min/1.73m²，7.1%的估计肾小球滤过率（eGFR）>150ml/min/1.73m²。在多因素分析中，女性性别和铁蛋白水平升高与微量白蛋白尿/大量白蛋白尿的存在显著相关。体重指数（BMI）增加和胰岛素抵抗稳态模型评估值与较低的估计肾小球滤过率（eGFR）显著相关。
大量接受减肥手术的严重肥胖青少年有早期肾功能障碍的证据。需要对这些个体在减肥手术后进行纵向研究，以确定这些肾脏异常在减肥治疗后是否可逆。
