Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), 17190, Salt, Spain.
Pediatrics, Dr. Trueta University Hospital, 17007, Girona, Spain.
Sci Rep. 2021 Jun 3;11(1):11702. doi: 10.1038/s41598-021-91162-x.
Associations between glomerular filtration rate (GFR) and cardiometabolic risk factors have been reported in adult and pediatric patients with renal disease. We aimed to assess the relationship between the estimated GFR (eGFR) and cardiometabolic risk factors in apparently healthy children. A longitudinal study in 401 asymptomatic Caucasian children (mean age 8 years) followed up after 4 years (mean age 12 years). GFR was estimated using the pediatric form of the FAS-equation. Children were classified at baseline according to their obesity status (normal weight and overweight) and according to eGFR levels (lower, average, and higher). The association of eGFR with anthropometric data [body mass index (BMI) and waist], blood pressure [systolic (SBP) and diastolic (DBP)], metabolic parameters [glucose, insulin resistance (HOMA-IR) and serum lipids], and renal ultrasonography measurements were assessed at baseline and follow-up. Baseline eGFR associated with several cardiometabolic risk factors at follow-up including higher waist, SBP, HOMA-IR, and kidney size (all p < 0.0001) in both normal weight and overweight children. In multivariate analysis, baseline eGFR was independently associated with follow-up HOMA-IR and SBP in both normal weight and overweight subjects (model R: 0.188-0.444), and with follow-up BMI and waist in overweight subjects (model R: 0.367-0.477). Moreover, children with higher filtration rates at baseline showed higher waist, SBP, DBP, HOMA-IR and renal size both at baseline and follow-up. eGFR is related to insulin resistance, blood pressure and adiposity measures in school-age children. eGFR may help to profile the cardiometabolic risk of children.
肾小球滤过率（GFR）与心血管代谢危险因素之间的关联已在患有肾脏疾病的成年和儿科患者中报道过。我们旨在评估在看似健康的儿童中估算的肾小球滤过率（eGFR）与心血管代谢危险因素之间的关系。在 401 名无症状的白种人儿童（平均年龄 8 岁）中进行了一项纵向研究，这些儿童在 4 年后（平均年龄 12 岁）接受了随访。使用 FAS 方程的儿科形式估算 GFR。根据肥胖状况（正常体重和超重）和 eGFR 水平（较低、平均和较高），在基线时对儿童进行分类。在基线和随访时，评估了 eGFR 与人体测量数据[体重指数（BMI）和腰围]、血压[收缩压（SBP）和舒张压（DBP)]、代谢参数[血糖、胰岛素抵抗（HOMA-IR）和血清脂质]以及肾脏超声测量值的相关性。在正常体重和超重儿童中，基线 eGFR 与随访时的几种心血管代谢危险因素相关，包括较高的腰围、SBP、HOMA-IR 和肾脏大小（所有 p 值均<0.0001）。在多元分析中，基线 eGFR 与正常体重和超重受试者的随访 HOMA-IR 和 SBP 独立相关（模型 R：0.188-0.444），与超重受试者的随访 BMI 和腰围相关（模型 R：0.367-0.477）。此外，基线时滤过率较高的儿童在基线和随访时的腰围、SBP、DBP、HOMA-IR 和肾脏大小均较高。eGFR 与学龄儿童的胰岛素抵抗、血压和肥胖测量值有关。eGFR 可能有助于评估儿童的心血管代谢风险。
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