Zhao Yong-Li, Liu Zheng-Juan, Bai Xue-Mei, Wang Yu-Chuan, Li Guo-Hua, Yan Xue-Yan
Department of Pediatrics, The Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, 116027, China.
Eur J Pediatr. 2015 Oct;174(10):1357-63. doi: 10.1007/s00431-015-2547-z. Epub 2015 Apr 22.
The main aim of this study was to evaluate the relationship between obesity and renal involvement in children with Henoch-Schönlein purpura (HSP). A retrospective study of 141 pediatric patients with HSP was conducted in our hospital. The clinical data of all patients were collected from the electronic medical record management system from January 2010 to June 2014. The possible risk factors of renal involvement, especially obesity, were analyzed using univariate and multivariate analyses. Renal involvement occurred in 45/141 of the patients. A univariate analysis showed that an age more than 7 years at onset, persistent purpura, obesity, time from symptoms onset to diagnosis more than 14 days, and decreased C3 all increased the risk of renal involvement in HSP. The forward stepwise logistic regression analysis indicated obesity (odds ratio (OR) 4.43, 95 % confidence interval (CI) 1.896 to 10.358), age more than 7 years at onset (OR 2.81, 95 % CI 1.142 to 6.907), and persistent purpura (OR 2.57, 95 % CI 1.119 to 5.909) were independent risk factors for renal involvement.
Our results show that obesity can increase the hazard of renal involvement in children with HSP and reconfirm that older age at onset and persistent purpura are the independent risk factors for renal involvement.
• There have been some reports that obesity was associated with the development of renal injury. • It is not clear whether obesity can increase the risk of renal involvement in children with HSP. What is New: • The main finding of this study is that obesity can increase the hazard of renal involvement in children with HSP.
本研究的主要目的是评估过敏性紫癜(HSP)患儿肥胖与肾脏受累之间的关系。我们医院对141例儿科HSP患者进行了回顾性研究。收集了2010年1月至2014年6月期间所有患者的临床数据,来自电子病历管理系统。使用单因素和多因素分析方法分析了肾脏受累的可能危险因素,尤其是肥胖。141例患者中有45例发生肾脏受累。单因素分析显示,发病年龄大于7岁、紫癜持续存在、肥胖、症状出现至诊断时间超过14天以及C3降低均增加了HSP患儿肾脏受累的风险。向前逐步逻辑回归分析表明,肥胖(比值比(OR)4.43,95%置信区间(CI)1.896至10.358)、发病年龄大于7岁(OR 2.81,95%CI 1.142至6.907)和紫癜持续存在(OR 2.57,95%CI 1.119至5.909)是肾脏受累的独立危险因素。
我们的结果表明,肥胖会增加HSP患儿肾脏受累的风险,并再次证实发病年龄较大和紫癜持续存在是肾脏受累的独立危险因素。
• 有一些报道称肥胖与肾损伤的发生有关。• 尚不清楚肥胖是否会增加HSP患儿肾脏受累的风险。新发现:• 本研究的主要发现是肥胖会增加HSP患儿肾脏受累的风险。