Lee Jeonghwan, Kim Hye Jin, Cho Belong, Park Jin Ho, Choi Ho Chun, Lee Cheol Min, Oh Seung Won, Kwon Hyuktae, Heo Nam Ju
Department of Internal Medicine, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
PLoS One. 2015 Oct 23;10(10):e0141364. doi: 10.1371/journal.pone.0141364. eCollection 2015.
Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography (CT) in healthy Korean adults. The study population included individuals aged 20-64 years who went a routine health check-up including an abdominal CT scan. We selected 4,378 individuals without diabetes and hypertension. Glomerular filtration rate was estimated using the CKD-EPI equation, and glomerular hyperfiltration was defined as the highest quintile of glomerular filtration rate. Abdominal adipose tissue areas were measured at the level of the umbilicus using a 16-detector CT scanner, and the cross-sectional area was calculated using Rapidia 2.8 CT software. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous adipose tissue area in men (OR = 1.74 (1.16-2.61), P for trend 0.016, for the comparisons of lowest vs. highest quartile) and visceral adipose tissue area in women (OR = 2.34 (1.46-3.75), P for trend < 0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m2, overweight ≥ 23 kg/m2), male subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (OR = 2.11 (1.17-3.80), P for trend = 0.009). Among women, the significance of visceral adipose tissue area on glomerular hyperfiltration resulted from the normal BMI group (OR = 2.14 (1.31-3.49), P for trend = 0.002). After menopause, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased (OR = 2.96 (1.21-7.25), P for trend = 0.013). Subcutaneous adipose tissue areas and visceral adipose tissue areas are positively associated with glomerular hyperfiltration in healthy Korean adult men and women, respectively. In post-menopausal women, visceral adipose tissue area shows significant positive association with glomerular hyperfiltration as in men.
肾小球高滤过被认为是肥胖人群进行性肾功能不全的早期标志物。本研究旨在确定健康韩国成年人中肾小球高滤过与通过计算机断层扫描(CT)测量的体脂分布之间的关系。研究人群包括年龄在20 - 64岁之间接受包括腹部CT扫描在内的常规健康检查的个体。我们选取了4378名无糖尿病和高血压的个体。使用CKD - EPI方程估算肾小球滤过率,肾小球高滤过定义为肾小球滤过率的最高五分位数。使用16排CT扫描仪在脐水平测量腹部脂肪组织面积,并使用Rapidia 2.8 CT软件计算横截面积。在多变量分析中,男性肾小球高滤过的患病率根据皮下脂肪组织面积显著增加(比值比[OR]=1.74(1.16 - 2.61),趋势P值=0.016,最低四分位数与最高四分位数比较),女性根据内脏脂肪组织面积显著增加(OR = 2.34(1.46 - 3.75),趋势P值<0.001)。按体重指数分层(正常<23 kg/m²,超重≥23 kg/m²)后,皮下脂肪组织较多的男性受试者,即使是体重指数正常组的,肾小球高滤过的患病率也较高(OR = 2.11(1.17 - 3.80),趋势P值=0.009)。在女性中,内脏脂肪组织面积对肾小球高滤过的影响在体重指数正常组中显著(OR = 2.14(1.31 - 3.49),趋势P值=0.002)。绝经后,肾小球高滤过与腹部皮下脂肪组织关联的比值比增加(OR = 2.96(1.21 - 7.25),趋势P值=0.013)。在健康韩国成年男性和女性中,皮下脂肪组织面积和内脏脂肪组织面积分别与肾小球高滤过呈正相关。在绝经后女性中,内脏脂肪组织面积与肾小球高滤过呈显著正相关,与男性情况相同。