Luo Kexue, Bian Jie, Wang Qinxian, Wang Jiesheng, Chen Fuxing, Li Hongchun, Jin Dong
Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.
Sir Run Run Shaw Hospital, International Medical Center, Zhejiang University, Zhejiang, China.
Turk J Gastroenterol. 2019 Jul;30(7):611-615. doi: 10.5152/tjg.2019.18343.
BACKGROUND/AIMS: This study investigated an association between obesity and impaired renal functions in elderly patients with nonalcoholic fatty liver disease (NAFLD) and evaluated the risk factors for chronic kidney disease (CKD) in these patients.
A cross-sectional study was performed involving 515 elderly patients (≥ 60 years old) with NAFLD. Demographics, body mass index (BMI), medical history, and laboratory parameters were compared for groups stratified by obesity (≥ 28 kg/m2) or CKD. An association between obesity and CKD was analyzed, and a multivariate logistic regression analysis was conducted for risk factors associated with CKD.
In the overall population, 28.7% were obese and 54.8% had CKD; there were more women (58.8%) than men. The prevalence of hypertension and diabetes was similar between the obese and nonobese groups and between the CKD and non-CKD groups. Obese patients had significantly higher levels of serum uric acid and estimated glomerular filtration rates when compared with the nonobese group. When compared with those without CKD, patients with CKD were significantly older in addition to having higher BMI and serum uric acid levels. The multivariate logistic regression analysis indicated that CKD was positively associated with age, BMI, and serum uric acid levels.
Elderly obese patients with NAFLD are at a higher risk of CKD. NAFLD patients with advanced age, greater BMI, or higher serum uric acid levels are more prone to developing CKD. The renal function of NAFLD patients should be closely monitored.
背景/目的:本研究调查了老年非酒精性脂肪性肝病(NAFLD)患者肥胖与肾功能受损之间的关联,并评估了这些患者慢性肾脏病(CKD)的危险因素。
对515例老年(≥60岁)NAFLD患者进行了一项横断面研究。比较了按肥胖(≥28kg/m²)或CKD分层的各组的人口统计学、体重指数(BMI)、病史和实验室参数。分析了肥胖与CKD之间的关联,并对与CKD相关的危险因素进行了多因素逻辑回归分析。
在总体人群中,28.7%为肥胖者,54.8%患有CKD;女性(58.8%)多于男性。肥胖组与非肥胖组之间以及CKD组与非CKD组之间高血压和糖尿病的患病率相似。与非肥胖组相比,肥胖患者的血清尿酸水平和估算肾小球滤过率显著更高。与无CKD的患者相比,CKD患者除了BMI和血清尿酸水平较高外,年龄也显著更大。多因素逻辑回归分析表明,CKD与年龄、BMI和血清尿酸水平呈正相关。
老年肥胖NAFLD患者患CKD的风险更高。年龄较大、BMI较高或血清尿酸水平较高的NAFLD患者更容易发生CKD。应密切监测NAFLD患者的肾功能。