Department of Medicine, Division of Nephrology, Koc University School of Medicine, 34010, Istanbul, Turkey.
Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
Int Urol Nephrol. 2022 Oct;54(10):2567-2579. doi: 10.1007/s11255-022-03160-1. Epub 2022 Mar 12.
Recent studies show that obese patients have worse outcomes in IgA nephropathy as compared to normal weight patients.
We performed a systematic review and meta-analysis of prospective, retrospective, randomized and nonrandomized studies, which studied the impact of obesity or high body mass index (BMI) on different parameters of IgA nephropathy prognosis and outcome. We searched through PubMed, Ovid/Medline, Web of Science, and the Cochrane Central Register of Controlled Trials (Wiley).
We included 16 studies in our final analysis with a total of 4258 patients. Overall, there was a significantly lower estimated glomerular filtration rate (eGFR) in IgA nephropathy patients with BMI in the overweight/obese range than in those with normal BMI (mean difference 6.01, 95% CI 2.78-9.24 ml/min/1.73 m, P < 0.001), but no significant difference in serum creatinine or proteinuria levels. No studies measured GFR. There were contradictory results regarding the relationship between BMI and blood pressure, histological parameters or outcomes in patients with IgA nephropathy.
Higher BMI in IgA nephropathy patients might be associated with lower kidney function, but this should be confirmed by measuring GFR. Evidence regarding other kidney damage parameters and outcomes is inconclusive.
最近的研究表明，与体重正常的患者相比，肥胖患者在 IgA 肾病中的预后更差。
我们对前瞻性、回顾性、随机和非随机研究进行了系统评价和荟萃分析，这些研究探讨了肥胖或高体重指数（BMI）对 IgA 肾病预后和结局不同参数的影响。我们在 PubMed、Ovid/Medline、Web of Science 和 Cochrane 对照试验中心注册库（Wiley）进行了检索。
我们最终分析纳入了 16 项研究，共 4258 例患者。总体而言，BMI 在超重/肥胖范围内的 IgA 肾病患者的估算肾小球滤过率（eGFR）明显低于 BMI 正常的患者（平均差异 6.01，95%置信区间 2.78-9.24 ml/min/1.73 m，P < 0.001），但血清肌酐或蛋白尿水平无显著差异。没有研究测量 GFR。BMI 与 IgA 肾病患者血压、组织学参数或结局之间的关系存在相互矛盾的结果。
IgA 肾病患者的 BMI 较高可能与肾功能下降有关，但这需要通过测量 GFR 来证实。关于其他肾脏损伤参数和结局的证据尚无定论。
