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供肾切除术患者内脏与皮下脂肪组织比例的影响

Impact of the Ratio of Visceral to Subcutaneous Adipose Tissue in Donor Nephrectomy Patients.

作者信息

Lee H H, Kang S K, Yoon Y E, Huh K H, Kim M S, Kim S I, Kim Y S, Han W K

机构信息

Department of Urology, Yonsei University College of Medicine, Urological Science Institute, Seoul, Korea; Department of Urology, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea.

Department of Urology, Yonsei University College of Medicine, Urological Science Institute, Seoul, Korea.

出版信息

Transplant Proc. 2017 Jun;49(5):940-943. doi: 10.1016/j.transproceed.2017.03.039.

Abstract

OBJECTIVE

It was reported that a metabolic syndrome affected the remaining renal function after living donor nephrectomy. However, the measurement of waist circumference is unclear because it cannot distinguish between visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). We investigate the clinical correlation between body adipose tissue and renal function recovery after living donor nephrectomy.

METHODS

From July 2013 to February 2015, 75 living kidney donors were enrolled. The VAT and SAT were measured by preoperative computed tomography (CT) scan. Body mass index (BMI), VAT, SAT, and VAT-to-SAT ratio were analyzed according to a postoperative renal function recovery. Receiver operating characteristic (ROC) was performed to predict estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m at postoperative 6 months for BMI, VAT, SAT, and VAT-to-SAT ratio.

RESULTS

The lowest value of eGFR (57.52 ± 11.20 mL/min/1.73 m) was measured at postoperative day 7. There was no statistically significant difference in eGFR between 1 month and 3 months. BMI, VAT, SAT, and VAT-to-SAT ratio showed a statistically significant correlation with each other (Pearson correlation, P < .05). Also, the recovery time of eGFR was correlated with VAT-to-SAT ratio; it was significant at postoperative 1, 3, and 6 months. VAT-to-SAT ratio (0.654, 95% confidence interval 0.525-0.783, P = .024) had higher predictive value in ROC.

CONCLUSION

We developed a new variable to predict the value of lower eGFR (less than 60 mL/min/1.73 m) at a postoperative 6 months in living kidney donor. According to a CT scan, VAT-to-SAT ratio can predict renal function recovery.

摘要

目的

据报道,代谢综合征会影响活体供肾肾切除术后的残余肾功能。然而,腰围测量并不明确,因为它无法区分内脏脂肪组织(VAT)和皮下脂肪组织(SAT)。我们研究活体供肾肾切除术后身体脂肪组织与肾功能恢复之间的临床相关性。

方法

2013年7月至2015年2月,纳入75名活体肾供体。术前通过计算机断层扫描(CT)测量VAT和SAT。根据术后肾功能恢复情况分析体重指数(BMI)、VAT、SAT和VAT与SAT的比值。绘制受试者工作特征(ROC)曲线,以预测BMI、VAT、SAT和VAT与SAT的比值在术后6个月时估计肾小球滤过率(eGFR)低于60 mL/min/1.73 m²的情况。

结果

术后第7天测得eGFR的最低值(57.52±11.20 mL/min/1.73 m²)。1个月和3个月时eGFR无统计学显著差异。BMI、VAT、SAT和VAT与SAT的比值之间存在统计学显著相关性(Pearson相关性,P<.05)。此外,eGFR的恢复时间与VAT与SAT的比值相关;在术后1个月、3个月和6个月时具有显著性。VAT与SAT的比值(0.654,95%置信区间0.525 - 0.783,P =.024)在ROC曲线中具有更高的预测价值。

结论

我们开发了一个新变量来预测活体肾供体术后6个月时较低eGFR(低于60 mL/min/1.73 m²)的值。根据CT扫描,VAT与SAT的比值可预测肾功能恢复情况。

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