Motie Marjan, Evangelista Lorraine S, Lombardo Dawn, Hoi Josiah, Horwich Tamara B, Hamilton Michele, Fonarow Gregg C
Program in Nursing Science, University of California Irvine, Irvine, CA, United States.
Program in Nursing Science, University of California Irvine, Irvine, CA, United States.
Diabetes Metab Syndr. 2017 Apr-Jun;11(2):95-98. doi: 10.1016/j.dsx.2016.06.026. Epub 2016 Jun 23.
The effect of intentional weight loss on glomerular filtration rate (GFR) in overweight and obese patients with heart failure (HF), diabetes mellitus (DM) and/or metabolic syndrome (MS) has not been studied. The purpose of the present study is to assess the short term effects of intentional weight loss on renal function in this population.
Fifty nine patients were recruited to participate in a 3-month intensive behavioral weight management intervention and received one of two standard structured energy-restricted meal plans (1200 or 1500kcal/day) based on their computed calorie deficit. Weight and renal function (serum creatinine, BUN and estimated glomerular filtration rate based on two formulas - Modification in Renal Disease Study (MDRD), and modified version of Cockcroft-Gault formula reported by Salazar Corcoran for obese patients (absolute and relative formulas) - were evaluated at baseline and at 3 months.
Participants had eGFR in the normal range at baseline and lost an average of 7.56±14.9 pounds (p<0.0001) over 3 months; however, there was no significant reduction in serum creatinine, BUN or eGFR.
This study provides evidence that intentional weight loss in overweight and obese patients with HF along with DM, and/or MS and normal baseline renal function does not adversely affect renal function overtime.
尚未研究过超重和肥胖的心力衰竭（HF）、糖尿病（DM）和/或代谢综合征（MS）患者进行有意减肥对肾小球滤过率（GFR）的影响。本研究的目的是评估该人群有意减肥对肾功能的短期影响。
招募了59名患者参加为期3个月的强化行为体重管理干预，并根据计算出的热量缺口接受两种标准的结构化能量限制饮食计划之一（1200或1500千卡/天）。在基线和3个月时评估体重和肾功能（血清肌酐、尿素氮以及基于两种公式——肾脏病研究修正公式（MDRD）和Salazar Corcoran报告的肥胖患者Cockcroft-Gault公式的修正版（绝对和相对公式）——估算的肾小球滤过率）。
参与者在基线时估算肾小球滤过率处于正常范围，3个月内平均体重减轻了7.56±14.9磅（p<0.0001）；然而，血清肌酐、尿素氮或估算肾小球滤过率没有显著降低。
本研究提供的证据表明，超重和肥胖的HF合并DM和/或MS且基线肾功能正常的患者进行有意减肥不会随时间推移对肾功能产生不利影响。
