超重青少年的肾小球高滤过

Glomerular hyperfiltration in excess weight adolescents.

作者信息

Iduoriyekemwen N J, Ibadin M O, Aikhionbare H A, Idogun S E, Abiodun M T

机构信息

Department of Child Health, University of Benin/University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria.

Department of Chemical Pathology, University of Benin/University of Benin Teaching Hospital, P.M.B. 1111, Benin City, Nigeria.

出版信息

Niger J Clin Pract. 2019 Jun;22(6):842-848. doi: 10.4103/njcp.njcp_123_18.

DOI:10.4103/njcp.njcp_123_18

PMID:31187771

Abstract

BACKGROUND

Childhood overweight/obesity burden is on the rise worldwide. Obesity affects virtually all organs. In the kidney, glomerular hyperfiltration that manifests as elevated glomerular filtration rate is a frequent manifestation in obesity. This adaptive renal manifestation to excess metabolic demand on the kidney, in children, has been studied mainly in the severely obese and is uncertain if it is present in less severe forms of excessive weight. In addition, glomerular hyperfiltration has been reported to be associated with high levels of the indicators of cardiometabolic risk, and these latter finding are solely from adult studies.

OBJECTIVE

To ascertain if glomerular hyperfiltration occurs in overweight and less severely obese children and to determine any significant relevance of some indicators of cardiometabolic risk associated with hyperfiltration.

SUBJECTS AND METHODS

This cross-sectional study involved 49 adolescents (28 overweight, 21 obese) and 49 normal weight adolescents. The participants were subjected to clinical examination, anthropometric measurement, laboratory investigation using standard techniques. Estimated glomerular filtration rates (eGFR) were calculated using the modified Schwartz equation. Hyperfiltration was defined as eGFR ≥140 ml/min/1.73 m.

RESULTS

Hyperfiltration was observed in 20 (40.8%) of the overweight/obese adolescents. The prevalence of hyperfiltration among the overweight and the obese adolescent was 24.5% and 16.3%, respectively. The mean estimated glomerular filtration rate of the overweight/obese adolescents was 141.0 ± 46.2 ml/min/1.73 m, whereas that of the normal weight adolescents was 99.2 ± 17.1 ml/min/1.73 m (P = 0.0001). A higher prevalence of hypertension was observed among the overweight/obese adolescent with glomerular hyperfiltration.

CONCLUSION

Glomerular hyperfiltration is not limited to morbidly obese children as the burden is also high in overweight and less severely obese adolescents.

摘要

背景

全球儿童超重/肥胖负担正在上升。肥胖几乎会影响所有器官。在肾脏方面，表现为肾小球滤过率升高的肾小球高滤过是肥胖中的常见表现。这种儿童期肾脏对代谢需求增加的适应性肾脏表现，主要在重度肥胖儿童中进行了研究，对于体重超标程度较轻的情况是否存在尚不确定。此外，据报道肾小球高滤过与心血管代谢风险指标的高水平有关，而这些发现仅来自成人研究。

目的

确定超重和肥胖程度较轻的儿童是否会出现肾小球高滤过，并确定与高滤过相关的一些心血管代谢风险指标的任何显著相关性。

对象与方法

这项横断面研究纳入了49名青少年（28名超重，21名肥胖）和49名体重正常的青少年。参与者接受了临床检查、人体测量、使用标准技术的实验室检查。使用改良的施瓦茨方程计算估计肾小球滤过率（eGFR）。高滤过定义为eGFR≥140 ml/min/1.73 m²。

结果

在超重/肥胖青少年中，有20名（40.8%）观察到高滤过。超重和肥胖青少年中的高滤过患病率分别为24.5%和16.3%。超重/肥胖青少年的平均估计肾小球滤过率为141.0±46.2 ml/min/1.73 m²，而体重正常青少年的平均估计肾小球滤过率为99.2±17.1 ml/min/1.73 m²（P = 0.0001）。在伴有肾小球高滤过的超重/肥胖青少年中，高血压患病率更高。