Kanda Eiichiro, Muneyuki Toshitaka, Suwa Kaname, Nakajima Kei
Department of Nephrology, Tokyo Kyosai Hospital, Meguro, Tokyo, Japan.
Center for life science and bioethics, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan.
PLoS One. 2015 Nov 23;10(11):e0143434. doi: 10.1371/journal.pone.0143434. eCollection 2015.
Obesity is associated with diabetes mellitus and cardiovascular diseases. However, it has been reported that weight loss is associated with incident chronic kidney disease (CKD) in healthy males. The purpose of this prospective cohort study is to investigate the effects of weight loss on kidney function in healthy people in terms of body mass index (BMI) and gender.
A total of 8447 nondiabetic healthy people were enrolled in the Saitama Cardiometabolic Disease and Organ Impairment Study, Japan. Relationships between estimated glomerular filtration rate (eGFR) change, BMI, and BMI change were evaluated using 3D-scatter plots with spline and generalized additive models (GAMs) adjusted for baseline characteristics.
The subjects were stratified into four groups according to BMI. The mean±standard deviations for males and females were, respectively, 40.11±9.49, and 40.3±9.71 years for age and 76.39±17.72 and 71.49±18.4 ml/min/1.73m2 for eGFR. GAMs showed that a decreasing BMI change (<-1 kg/m2/year) was associated with a decreasing eGFR change in males with high normal BMIs (22 kg/m2≤BMI<25 kg/m2). A decreasing BMI change (<-2 kg/m2/year) was associated with an increasing eGFR change in overweight males (25 kg/m2≤BMI). Among underweight females (BMI<18.5 kg/m2), decreasing BMI was observed with decreasing eGFR.
These findings suggest that the benefit and risk of weight loss in relation to kidney function differs depending on BMI and weight loss speed, especially in males.
肥胖与糖尿病和心血管疾病相关。然而，有报道称体重减轻与健康男性发生慢性肾脏病（CKD）有关。这项前瞻性队列研究的目的是根据体重指数（BMI）和性别，研究体重减轻对健康人群肾功能的影响。
共有8447名非糖尿病健康人群纳入了日本埼玉县心血管代谢疾病和器官损害研究。使用经基线特征调整的样条和广义相加模型（GAM）的三维散点图，评估估计肾小球滤过率（eGFR）变化、BMI和BMI变化之间的关系。
根据BMI将受试者分为四组。男性和女性的年龄均值±标准差分别为40.11±9.49岁和40.11±9.49岁，eGFR分别为76.39±17.72和71.49±18.4 ml/min/1.73m²。GAM显示，BMI变化降低（<-1 kg/m²/年）与高正常BMI（22 kg/m²≤BMI<25 kg/m²）男性的eGFR变化降低相关。BMI变化降低（<-2 kg/m²/年）与超重男性（25 kg/m²≤BMI）的eGFR变化增加相关。在体重过轻的女性（BMI<18.5 kg/m²）中，观察到eGFR降低时BMI也降低。
这些发现表明，体重减轻对肾功能的益处和风险因BMI和体重减轻速度而异，尤其是在男性中。
