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比较局灶节段性肾小球硬化症与其他原发性肾小球肾炎在肝脂肪变性和代谢综合征参数方面的差异。

Comparison of focal segmental glomerulosclerosis and other primary glomerulonephrites in terms of parameters of hepatic steatosis and metabolic syndrome.

机构信息

Department of Internal Medicine, University of Health Sciences Sultan 2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

Department of Nephrology, University of Health Sciences Sultan2. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.

出版信息

Int Urol Nephrol. 2023 Oct;55(10):2557-2566. doi: 10.1007/s11255-023-03536-x. Epub 2023 Mar 11.

Abstract

PURPOSE

The increasing frequency of coexistence of focal segmental glomerulosclerosis (FSGS) and obesity-associated glomerulopathy and the relationship between metabolic syndrome components and chronic kidney disease have been demonstrated in studies. Based on this information, in this study, we aimed to compare FSGS and other primary glomerulonephritis diagnoses in terms of parameters of metabolic syndrome and hepatic steatosis.

MATERIALS AND METHODS

In our study, the data of 44 patients who were diagnosed FSGS through kidney biopsy and 38 patients with any other primary glomerulonephritis diagnoses in our nephrology clinic were retrospectively analyzed. Patients were divided into two groups: FSGS and other primary glomerulonephritis diagnoses, and they were examined in terms of their demographic data, laboratory parameters, body composition measurements, and the presence of hepatic steatosis, as shown using liver ultrasonography.

RESULTS

In the comparative analysis of patients with FSGS and other primary glomerulonephritis diagnoses, with the increase in age increased the risk of FSGS by 1.12 times, the increase in BMI ​​increased the risk of FSGS by 1.67 times, while with the decrease in waist circumference decreased the risk of FSGS by ​​0.88 times, the decrease in HbA1c decreased the risk of FSGS by ​​0.12 times, and the presence of hepatic steatosis increased the risk of FSGS by 20.24 times.

CONCLUSION

The presence of hepatic steatosis, an increase in waist circumference and BMI values, which are body components favoring obesity, and an increase in HbA1c, which is a marker for hyperglycemia and insulin resistance, are greater risk factors for the development of FSGS compared with other primary glomerulonephritis diagnoses.

摘要

目的

研究已经表明,局灶节段性肾小球硬化症(FSGS)与肥胖相关性肾小球病共存的频率不断增加,代谢综合征成分与慢性肾脏病之间存在一定关系。基于这些信息,本研究旨在比较 FSGS 与其他原发性肾小球肾炎诊断在代谢综合征和肝脂肪变性参数方面的差异。

材料和方法

本研究回顾性分析了在我院肾脏科通过肾活检诊断为 FSGS 的 44 例患者和诊断为其他原发性肾小球肾炎的 38 例患者的临床资料。患者分为 FSGS 组和其他原发性肾小球肾炎组,比较两组患者的一般资料、实验室指标、体成分、肝脂肪变性的检出情况。

结果

在 FSGS 组和其他原发性肾小球肾炎组患者的比较分析中,年龄每增加 1 岁,FSGS 的发病风险增加 1.12 倍,BMI 每增加 1kg/m2,FSGS 的发病风险增加 1.67 倍,腰围每减少 1cm,FSGS 的发病风险减少 0.88 倍,HbA1c 每降低 0.1%,FSGS 的发病风险减少 0.12 倍,肝脂肪变性的存在使 FSGS 的发病风险增加 20.24 倍。

结论

与其他原发性肾小球肾炎诊断相比,肝脂肪变性、腰围和 BMI 等肥胖相关体成分的增加、HbA1c 等提示高血糖和胰岛素抵抗的标志物的增加是 FSGS 发病的更大危险因素。

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