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内脏肥胖与肾功能:来自 SPECT-China 的观察性研究。

Visceral adiposity and renal function: an observational study from SPECT-China.

机构信息

Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200011, China.

出版信息

Lipids Health Dis. 2017 Oct 27;16(1):205. doi: 10.1186/s12944-017-0597-0.

Abstract

BACKGROUND

Lipid accumulation product (LAP) is a novel and effective index of visceral adiposity distribution based on waist circumference and triglycerides concentration. Few studies investigated the relationship between LAP and eGFR. We aimed to explore whether LAP was associated with declined renal function (eGFR < 60 mL/min/1.73m), and also whether it exhibited obvious superiority in predicting kidney impairment compared with other obesity indices.

METHODS

In this cross-sectional study, 10,012 subjects were recruited from 22 sites in East China. LAP was calculated with the following formula: (WC-65) x TG for males, (WC-58) x TG for females.

RESULTS

4.7% participants with declined renal function had a higher LAP quartile. LAP was strongly associated with eGFR level (Beta: -0.073, P < 0.001) and declined renal function (P < 0.001) even after adjustment for age, sex, smoking, drinking, diabetes and hypertension. The risk of renal dysfunction increased 2.32-fold for the highest quartile LAP relative to the lowest quartile (OR: 2.32, 95%CI:1.52-3.53, P < 0.001). LAP exerted the largest area under the curve among different obesity indices (AUC ROC:0.644, 95%CI: 0.618-0.670, P < 0.001).

CONCLUSIONS

Our findings showed that LAP strongly associated with declined renal function and could be one of markers for predicting the risk of renal dysfunction in the general Chinese population.

TRIAL REGISTRATION

ChiCTR-ECS-14005052 (WHO international clinical trials register platform in China). Registered 20 July 2014.

摘要

背景

脂联素水平(LAP)是一种新的、有效的基于腰围和甘油三酯浓度的内脏脂肪分布指标。目前,关于 LAP 与肾小球滤过率(eGFR)之间关系的研究较少。本研究旨在探讨 LAP 是否与肾功能下降(eGFR<60mL/min/1.73m)相关,以及与其他肥胖指标相比,LAP 预测肾功能损害是否具有明显优势。

方法

本横断面研究共纳入华东地区 22 个中心的 10012 例受试者。LAP 采用以下公式计算:男性:(WC-65)×TG;女性:(WC-58)×TG。

结果

4.7%的肾功能下降患者的 LAP 四分位间距较高。LAP 与 eGFR 水平呈负相关(β=-0.073,P<0.001),且与肾功能下降显著相关(P<0.001),即使在校正年龄、性别、吸烟、饮酒、糖尿病和高血压后也是如此。与 LAP 最低四分位间距相比,LAP 最高四分位间距的肾功能障碍风险增加 2.32 倍(OR:2.32,95%CI:1.52-3.53,P<0.001)。在不同肥胖指标中,LAP 的曲线下面积最大(AUC ROC:0.644,95%CI:0.618-0.670,P<0.001)。

结论

本研究结果表明,LAP 与肾功能下降密切相关,可能是预测中国一般人群肾功能障碍风险的标志物之一。

试验注册

ChiCTR-ECS-14005052(世界卫生组织国际临床试验注册平台在中国的注册号)。于 2014 年 7 月 20 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a20/5658976/7e72b6e817dd/12944_2017_597_Fig1_HTML.jpg

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