Yu Shasha, Yang Hongmei, Guo Xiaofan, Zheng Liqiang, Sun Yingxian
Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.
Department of Clinical Epidemiology, Shenjing Hospital of China Medical University, Shenyang 110003, China.
Int J Environ Res Public Health. 2016 May 27;13(6):540. doi: 10.3390/ijerph13060540.
Obesity contributes to reduced kidney function; however, whether this is due to obesity itself or the metabolic abnormalities that accompany it is unclear. Besides, most previous studies enrolled participants with moderate or severe stage of chronic kidney disease. In the present study, we aim to investigate the possible relationship between obesity, metabolic abnormalities and mildly reduced estimated glomerular filtration rate (eGFR). A total of 11,127 Chinese participants (age ≥ 35 years) were enrolled in a survey conducted from January 2012 to August 2013. eGFR 60-90 mL/min/1.73 m² was defined as mildly reduced eGFR. Obese phenotype was divided into four types: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically abnormal non-obese (MANO) and metabolically abnormal obese (MAO). Among all participants, 1941 (17.4%) of them had mildly reduced eGFR (16.7% for men and 18.1% for women, p = 0.025). The prevalence of obese phenotype was 22.5% for MHNO, 9.1% for MHO, 32.1% for MANO and 36.4% for MAO. The prevalence of mildly reduced eGFR was 9.0% among MHNO, 7.0% among MHO, 22.6% among MANO and 20.7% among MAO (p < 0.001). Multivariate logistic regression analysis revealed that obese phenotype did not statically contributed to mildly reduced eGFR (MHO: OR = 1.107, p = 0.662; MANO: OR = 0.800, p = 0.127; MAO: OR = 1.119, p = 0.525). However, gender (OR = 1.475, p < 0.001), aging (OR = 1.283, p < 0.001), dyslipidemia (OR = 1.544, 95%CI: 1.315, 1.814, p < 0.001) and hyperglycemia (OR = 1.247, 95%CI: 1.068, 1.455, p = 0.005) was associated with increased risk of mild reduced eGFR. Among the general population from rural Northeast China, mildly reduced eGFR was associated with metabolic disorders like dyslipidemia and hyperglycemia, but not obesity.
肥胖会导致肾功能下降；然而，这是由于肥胖本身还是伴随肥胖的代谢异常尚不清楚。此外，以前的大多数研究纳入的是中度或重度慢性肾病患者。在本研究中，我们旨在调查肥胖、代谢异常与轻度降低的估计肾小球滤过率（eGFR）之间的可能关系。2012年1月至2013年8月进行的一项调查共纳入了11127名中国参与者（年龄≥35岁）。eGFR 60 - 90 mL/min/1.73 m²被定义为轻度降低的eGFR。肥胖表型分为四种类型：代谢健康非肥胖（MHNO）、代谢健康肥胖（MHO）、代谢异常非肥胖（MANO）和代谢异常肥胖（MAO）。在所有参与者中，1941人（17.4%）的eGFR轻度降低（男性为16.7%，女性为18.1%，p = 0.025）。肥胖表型的患病率在MHNO中为22.5%，在MHO中为9.1%，在MANO中为32.1%，在MAO中为36.4%。eGFR轻度降低的患病率在MHNO中为9.0%，在MHO中为7.0%，在MANO中为22.6%，在MAO中为20.7%（p < 0.001）。多因素逻辑回归分析显示，肥胖表型对eGFR轻度降低没有统计学贡献（MHO：OR = 1.107，p = 0.662；MANO：OR = 0.800，p = 0.127；MAO：OR = 1.119，p = 0.525）。然而，性别（OR = 1.475，p < 0.001）、年龄（OR = 1.283，p < 0.001）、血脂异常（OR = 1.544，95%CI：1.315，1.814，p < 0.001）和高血糖（OR = 1.247，95%CI：1.068，1.455，p = 0.005）与eGFR轻度降低风险增加相关。在中国东北农村的普通人群中，eGFR轻度降低与血脂异常和高血糖等代谢紊乱有关，但与肥胖无关。
