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老年女性肥胖的人体测量指标与慢性肾脏病的关联

Association of anthropometric measures of obesity and chronic kidney disease in elderly women.

作者信息

Jaroszynski Andrzej, Dereziński Tadeusz, Jaroszyńska Anna, Zapolski Tomasz, Wąsikowska Beata, Wysokiński Andrzej, Jawień Arkadiusz, Załuska Wojciech, Horoch Andrzej

机构信息

Department of Family Medicine, Medical University of Lublin, Poland.

Out-Patient Clinic Esculap Gniewkowo,Gniewkowo, Poland.

出版信息

Ann Agric Environ Med. 2016 Dec 23;23(4):636-640. doi: 10.5604/12321966.1226859.

Abstract

INTRODUCTION AND OBJECTIVE

Growing evidence suggests that obesity is an important contributor to the development of chronic kidney disease (CKD). The relationship between obesity and CKD is complex and not completely understood, and the best anthropometric index of obesity in predicting CKD is controversial. This study aimed to determine the best anthropometric index of obesity in predicting CKD in a population of elderly women.

MATERIALS AND METHODS

Anthropometric indexes of obesity including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WheiR) and waist-to-hip-ratio (WHR), were obtained in 730 selected females. Biochemical measurements including blood glucose, lipid profile, and 2-h postprandial blood glucose were performed. GFR was estimated by using CKD-EPI equation.

RESULTS

The prevalence of CKD stage ≥ 3 was 12.2%. Overweight and obesity was found in 50% and 36% of participants, respectively. Increased central fat distribution, as defined by WheiR, WC and WHR, was found in 89.6%, 91.7% and 89.4% individuals, respectively. Univariate linear regression analysis showed positive correlations between CKD and age (p<0.001), BMI (p<0.001), WC (p<0.001), WHR (p=0.007), WheiR (p<0.001), diabetes (p=0.002), as well as triglicerydes (p=0.031), and negative correlation between CKD and HDL level (p=0.017). Multivariable analysis demonstrated that hypertension, diabetes, WC and WheiR were independent predictors of CKD. The area under the receiver operating characteristics curve was best for WheiR (0.647), followed by WC (0.620), BMI (0.616), and WHR (0.532).

CONCLUSIONS

Abdominal obesity is an important predictor of CKD. Of commonly used anthropometric parameters of obesity WheiR ≥ 0.6 is particularly associated with CKD in elderly females.

摘要

引言与目的

越来越多的证据表明,肥胖是慢性肾脏病(CKD)发生发展的重要因素。肥胖与CKD之间的关系复杂且尚未完全明确,肥胖用于预测CKD的最佳人体测量指标存在争议。本研究旨在确定老年女性人群中肥胖用于预测CKD的最佳人体测量指标。

材料与方法

选取730名女性,获取包括体重指数(BMI)、腰围(WC)、腰高比(WheiR)和腰臀比(WHR)在内的肥胖人体测量指标。进行包括血糖、血脂谱和餐后2小时血糖在内的生化检测。采用CKD-EPI方程估算肾小球滤过率(GFR)。

结果

CKD≥3期的患病率为12.2%。分别有50%和36%的参与者超重和肥胖。根据WheiR、WC和WHR定义,分别有89.6%、91.7%和89.4%的个体存在中心性脂肪分布增加。单变量线性回归分析显示,CKD与年龄(p<0.001)、BMI(p<0.001)、WC(p<0.001)、WHR(p=0.007)、WheiR(p<0.001)、糖尿病(p=0.002)以及甘油三酯(p=0.031)呈正相关,与高密度脂蛋白水平呈负相关(p=0.017)。多变量分析表明,高血压、糖尿病、WC和WheiR是CKD的独立预测因素。受试者工作特征曲线下面积以WheiR最大(0.647),其次是WC(0.620)、BMI(0.616)和WHR(0.532)。

结论

腹型肥胖是CKD的重要预测因素。在常用的肥胖人体测量参数中,WheiR≥0.6与老年女性CKD尤其相关。

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