Sarathy Harini, Henriquez Gabriela, Abramowitz Matthew K, Kramer Holly, Rosas Sylvia E, Johns Tanya, Kumar Juhi, Skversky Amy, Kaskel Frederick, Melamed Michal L
Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, New York, United States of America.
Department of Pediatrics, Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, New York, United States of America.
PLoS One. 2016 May 25;11(5):e0153588. doi: 10.1371/journal.pone.0153588. eCollection 2016.
Kidney dysfunction in obesity may be independent of and may precede the development of hypertension and/or diabetes mellitus. We aimed to examine if abdominal obesity is associated with early markers of CKD in a young healthy population and whether these associations differ by race and/or ethnicity.
We analyzed data from the NHANES 1999-2010 for 6918 young adults ages 20-40 years. Abdominal obesity was defined by gender criteria of waist circumference. CKD markers included estimated glomerular filtration rate and albuminuria ≥30 mg/g. Race stratified analyses were done overall and in subgroups with normal blood pressures, normoglycemia and normal insulin sensitivity. Awareness of CKD was assessed in participants with albuminuria.
Abdominal obesity was present in over one-third of all young adults and was more prevalent among non-Hispanic blacks (45.4%) versus Mexican-Americans (40.6%) or non-Hispanic whites (37.4%) (P-value = 0.004). Mexican-American young adults with abdominal obesity had a higher odds of albuminuria even among those with normal blood pressure, normal glucose, and normal insulin sensitivity [adjusted odds ratio 4.5; 95% confidence interval (1.6-12.2), p = 0.004]. Less than 5% of young adults with albuminuria of all races and ethnicities had been told they had kidney disease.
Abdominal obesity in young adults, especially in Mexican-Americans, is independently associated with albuminuria even with normal blood pressures, normoglycemia and normal insulin levels. Greater awareness of CKD is needed to protect this young population from long-standing exposure to abdominal obesity and early progressive renal disease.
肥胖中的肾功能不全可能独立于高血压和/或糖尿病的发生，且可能先于它们出现。我们旨在研究在年轻健康人群中腹部肥胖是否与慢性肾脏病（CKD）的早期标志物相关，以及这些关联是否因种族和/或族裔而有所不同。
我们分析了1999 - 2010年美国国家健康与营养检查调查（NHANES）中6918名20 - 40岁年轻成年人的数据。腹部肥胖根据腰围的性别标准来定义。CKD标志物包括估算肾小球滤过率和尿白蛋白≥30mg/g。总体上以及在血压正常、血糖正常和胰岛素敏感性正常的亚组中进行了种族分层分析。对有蛋白尿的参与者评估其对CKD的知晓情况。
超过三分之一的年轻成年人存在腹部肥胖，非西班牙裔黑人（45.4%）中的腹部肥胖比墨西哥裔美国人（40.6%）或非西班牙裔白人（37.4%）更普遍（P值 = 0.004）。即使在血压正常、血糖正常和胰岛素敏感性正常的墨西哥裔美国年轻成年人中，腹部肥胖者出现蛋白尿的几率也更高[调整后的优势比为4.5；95%置信区间（1.6 - 12.2），p = 0.004]。所有种族和族裔中有蛋白尿的年轻成年人中，不到5%的人被告知自己患有肾脏疾病。
年轻成年人中的腹部肥胖，尤其是墨西哥裔美国人，即使在血压正常、血糖正常和胰岛素水平正常的情况下，也与蛋白尿独立相关。需要提高对CKD的认识，以保护这一年轻人群免受长期腹部肥胖和早期进行性肾脏疾病的影响。
