Clinical Metabolomics Center, China Pharmaceutical University, Nanjing, China.
State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, China.
Front Endocrinol (Lausanne). 2020 Oct 6;11:534294. doi: 10.3389/fendo.2020.534294. eCollection 2020.
To determine the relationship between obesity and the risk of AKI after cardiac surgery (CS-AKI) in a cohort study.
A total of 1,601 patients undergoing cardiac surgery were collected and their incidence of CS-AKI was recorded. They were divided into underweight, normal weight, overweight, and obese groups. Logistic regression was used to estimate the association between BMI (body mass index) and CS-AKI risk. Then, a meta-analysis of published cohort studies was conducted to confirm this result using PubMed and Embase databases.
A significant association was observed in this independent cohort after adjusting age, gender, hypertension and New York Heart Association classification (NYHA) class. Compared with normal BMI group (18.5 ≤ BMI < 24.0), the individuals with aberrant BMI level had an increased AKI risk (OR: 1.68, 95% CI: 1.01-2.78) for BMI < 18.5 group and (OR: 1.43, 95% CI: 0.96-2.15) for BMI ≥ 28.0. Interestingly, the U-shape curve showed the CS-AKI risk reduced with the increasing of BMI when BMI ≤ 24.0. As BMI increases with BMI > 24.0, the risk of developing CS-AKI increased significantly. In the confirmed meta-analysis, compared with normal weight, overweight group with cardiac surgery had higher AKI risk (OR: 1.28, 95% CI: 1.16-1.41, = 0.49). The similar association was found in obesity subgroup (OR: 1.79, 95% CI: 1.57-2.03, = 0.42).
In conclusion, the results suggested that abnormal BMI was a risk factor for CS-AKI independently.
在一项队列研究中，确定肥胖与心脏手术后急性肾损伤（CS-AKI）风险之间的关系。
共收集了 1601 名接受心脏手术的患者，记录了他们 CS-AKI 的发生率。他们被分为体重不足、正常体重、超重和肥胖组。使用逻辑回归估计 BMI（体重指数）与 CS-AKI 风险之间的关联。然后，使用 PubMed 和 Embase 数据库对已发表的队列研究进行荟萃分析，以确认这一结果。
在调整年龄、性别、高血压和纽约心脏协会（NYHA）分类后，在这个独立的队列中观察到了显著的相关性。与正常 BMI 组（18.5≤BMI＜24.0）相比，BMI 异常的个体发生 AKI 的风险增加（OR：1.68，95%CI：1.01-2.78），BMI＜18.5 组（OR：1.43，95%CI：0.96-2.15）和 BMI≥28.0 组（OR：1.43，95%CI：0.96-2.15）。有趣的是，U 形曲线显示，当 BMI≤24.0 时，随着 BMI 的增加，CS-AKI 的风险降低。随着 BMI 超过 24.0，发生 CS-AKI 的风险显著增加。在确认的荟萃分析中，与正常体重相比，超重的心脏手术患者 AKI 风险更高（OR：1.28，95%CI：1.16-1.41， = 0.49）。在肥胖亚组中也发现了类似的关联（OR：1.79，95%CI：1.57-2.03， = 0.42）。
总之，结果表明，异常 BMI 是 CS-AKI 的独立危险因素。
