Murai-Takeda Ayano, Kanda Takeshi, Azegami Tatsuhiko, Hirose Hiroshi, Inokuchi Mikako, Tokuyama Hirobumi, Wakino Shu, Tokumura Mitsuaki, Kawabe Hiroshi, Mori Masaaki, Itoh Hiroshi
Health Center, Keio University, Yokohama, Japan.
Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Clin Exp Nephrol. 2019 Dec;23(12):1364-1372. doi: 10.1007/s10157-019-01784-9. Epub 2019 Sep 7.
Low birth weight (LBW) is a risk factor for chronic kidney disease (CKD) in later life and is becoming increasingly common in developed countries, including Japan. Furthermore, a serial decrease in birth weight has been associated with an increasing prevalence of CKD stage 2 in male Japanese adolescents. Sex-specific differences affect CKD susceptibility, and the association between birth weight and CKD in women, has not been elucidated. In this study, we investigated the sex-specific effect of LBW on renal function.
Annual cross-sectional data of 2417 Japanese adolescents (males 1736; females 681), aged 15-16 years, were evaluated over 8 years (2007-2014).
Over the study period, mean birth weights decreased significantly in males (p < 0.01) and females (p < 0.05). Furthermore, both sexes showed significant decrease in estimated glomerular filtration rates corresponding to the birth weight reduction. The prevalence of CKD stage 2 also increased in males (from 26.0 to 32.4%, p < 0.01) and females (from 6.3 to 18.5%, p < 0.05). The incidence of CKD stage 2 was significantly related to history of LBW (males: odds ratio 1.73; 95% confidence interval 1.06-2.80; p < 0.05; females: odds ratio 3.29; 95% confidence interval 1.25-8.02; p < 0.05).
Our data revealed that renal function and birth weight have decreased over time, in healthy Japanese adolescents. In view of the recent declining trend demonstrated by birth weight in Japan, we speculate that the prevalence of CKD might increase in the future.
低出生体重是日后患慢性肾脏病(CKD)的一个风险因素,且在包括日本在内的发达国家正变得越来越普遍。此外,出生体重的连续下降与日本男性青少年中CKD 2期患病率的增加有关。性别差异会影响CKD易感性,而女性出生体重与CKD之间的关联尚未阐明。在本研究中,我们调查了低出生体重对肾功能的性别特异性影响。
对2417名15至16岁日本青少年(男性1736名;女性681名)的年度横断面数据进行了为期8年(2007 - 2014年)的评估。
在研究期间,男性(p < 0.01)和女性(p < 0.05)的平均出生体重均显著下降。此外,两性的估计肾小球滤过率均随出生体重的降低而显著下降。CKD 2期的患病率在男性中也有所增加(从26.0%增至32.4%,p < 0.01),在女性中同样增加(从6.3%增至18.5%,p < 0.05)。CKD 2期的发病率与低出生体重史显著相关(男性:比值比1.73;95%置信区间1.06 - 2.80;p < 0.05;女性:比值比3.29;95%置信区间1.25 - 8.02;p < 0.05)。
我们的数据显示健康日本青少年的肾功能和出生体重随时间下降。鉴于日本近期出生体重呈下降趋势,我们推测未来CKD的患病率可能会增加。