Institute of Chemistry, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, USA.
Sci Rep. 2020 Dec 3;10(1):21154. doi: 10.1038/s41598-020-78382-3.
Obesity has been firmly established as a major risk factor for common disease states including hypertension, type 2 diabetes mellitus, and chronic kidney disease. Increased body mass index (BMI) contributes to the activation of both the systemic and intra-tubular renin angiotensin systems (RAS), which are in turn associated with increased blood pressure (BP) and kidney damage. In this cross-sectional study, 43 subjects of normal or increased body weight were examined in order to determine the correlation of BMI or body fat mass (BFM) with blood pressure, fasting blood glucose (FBG), and urinary kidney injury markers such as interleukin-18 (IL-18), connective tissue growth factor (CTGF), neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 (KIM-1). Our results showed that: (1) subjects with increased body weight showed significantly higher BP, BFM, total body water and metabolic age; (2) BMI was positively correlated to both systolic (R = 0.1384, P = 0.01) and diastolic BP (R = 0.2437, P = 0.0008); (3) BFM was positively correlated to DBP (R = 0.1232, P = 0.02) and partially correlated to urine protein (R = 0.047, P = 0.12) and FBG (R = 0.07, P = 0.06); (4) overweight young adults had higher urinary mRNA levels of renin, angiotensinogen, IL-18 and CTGF. These suggest that BMI directly affects BP, kidney injury markers, and the activation of the intra-tubular RAS even in normotensive young adults. Given that BMI measurements and urine analyses are non-invasive, our findings may pave the way to developing a new and simple method of screening for the risk of chronic kidney disease in adults.
肥胖已被明确确立为包括高血压、2 型糖尿病和慢性肾脏病在内的常见疾病状态的主要危险因素。较高的体重指数 (BMI) 会导致全身和肾小管内肾素血管紧张素系统 (RAS) 的激活,而这反过来又与血压升高和肾脏损伤有关。在这项横断面研究中,检查了 43 名体重正常或超重的受试者,以确定 BMI 或体脂肪量 (BFM) 与血压、空腹血糖 (FBG) 以及尿肾损伤标志物(如白细胞介素-18 (IL-18)、结缔组织生长因子 (CTGF)、中性粒细胞明胶酶相关脂质运载蛋白和肾损伤分子-1 (KIM-1))之间的相关性。我们的结果表明:(1) 体重增加的受试者的血压、BFM、总体水量和代谢年龄明显更高;(2) BMI 与收缩压 (R = 0.1384, P = 0.01) 和舒张压 (R = 0.2437, P = 0.0008) 均呈正相关;(3) BFM 与 DBP 呈正相关 (R = 0.1232, P = 0.02),部分与尿蛋白 (R = 0.047, P = 0.12) 和 FBG (R = 0.07, P = 0.06) 呈正相关;(4) 超重的年轻成年人尿液中肾素、血管紧张素原、IL-18 和 CTGF 的 mRNA 水平较高。这些表明,即使在血压正常的年轻成年人中,BMI 也直接影响血压、肾损伤标志物和肾小管内 RAS 的激活。鉴于 BMI 测量和尿液分析是非侵入性的,我们的发现可能为开发一种新的、简单的方法来筛查成年人慢性肾脏病的风险铺平道路。