Tian Qiuwei, He Caixia, Wang Zisai, Hun Marady, Fu Yi-Cheng, Zhao Mingyi, He Qingnan
Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China.
Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China.
Front Endocrinol (Lausanne). 2023 Jul 26;14:1138513. doi: 10.3389/fendo.2023.1138513. eCollection 2023.
Globally, chronic kidney disease (CKD) is a growing public health concern. Serum uric acid (SUA) is an easily detectable and readily available biochemical indicator that has long been recognized as an independent risk factor for CKD. In addition, studies have indicated a potential relationship between SUA and body mass index (BMI). However, studies on the effect of SUA levels on the estimated glomerular filtration rate (eGFR) in adolescents with different BMIs are very rare.
Weighted multiple regression analysis was used to estimate the independent relationship between SUA and log-transformed eGFR. Additionally, we used a weighted generalized additive model and smooth curve fitting to describe the nonlinear relationships in the subgroup analysis.
First, SUA was negatively associated with log-transformed eGFR even after adjusting for all covariates (β=-0.0177, 95% CI: -0.0203-0.0151, P<0.0001). Second, the results of the stratified analysis found that after adjusting for all covariates, the decrease in log-transformed eGFR due to changes in per SUA levels (Per 1, mg/dL increase) was elevated in female adolescents (β=-0.0177, 95% CI: -0.0216, -0.0138, P<0.0001), adolescents aged 12-15 years (β=-0.0163, 95% CI: -0.0200, -0.0125, P<0.0001) and black (β=-0.0199, 95% CI: -0.0251, -0.0148, P<0.0001) adolescents. Furthermore, we found that adolescents with a higher BMI had higher SUA levels, and the effect of SUA on eGFR was significantly higher in underweight adolescents (β=-0.0386, 95% CI: (-0.0550, -0.0223), P<0.0001).
SUA was negatively associated with the eGFR in adolescents aged 12-19 years. Furthermore, we found for the first time that SUA affects the eGFR differently in adolescents with different BMIs. This effect was particularly significant in underweight adolescents.
在全球范围内，慢性肾脏病（CKD）日益引起公众健康关注。血清尿酸（SUA）是一种易于检测且随时可得的生化指标，长期以来一直被认为是CKD的独立危险因素。此外，研究表明SUA与体重指数（BMI）之间存在潜在关系。然而，关于不同BMI的青少年中SUA水平对估计肾小球滤过率（eGFR）影响的研究非常罕见。
采用加权多元回归分析来估计SUA与对数转换后的eGFR之间的独立关系。此外，我们使用加权广义相加模型和平滑曲线拟合来描述亚组分析中的非线性关系。
首先，即使在调整所有协变量后，SUA与对数转换后的eGFR仍呈负相关（β=-0.0177，95%CI：-0.0203 - 0.0151，P<0.0001）。其次，分层分析结果发现，在调整所有协变量后，女性青少年（β=-0.0177，95%CI：-0.0216，-0.0138，P<0.0001）、12 - 15岁青少年（β=-0.0163，95%CI：-0.0200，-0.0125，P<0.0001）和黑人青少年（β=-0.0199，95%CI：-0.0251，-0.0148）中，每升高1mg/dL的SUA水平导致的对数转换后eGFR下降幅度增大。此外，我们发现BMI较高的青少年SUA水平较高，且SUA对eGFR的影响在体重过轻的青少年中显著更高（β=-0.0386，95%CI：（-0.0550，-0.0223），P<0.0001）。
SUA与12 - 19岁青少年的eGFR呈负相关。此外，我们首次发现SUA对不同BMI的青少年的eGFR影响不同。这种影响在体重过轻的青少年中尤为显著。
