Bragina Anna, Rodionova Yulia, Osadchiy Konstantin, Bayutina Daria, Vasilchenko Maria K, Fomin Alexander, Podzolkov Valeriy
Department of Faculty Therapy No. 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
J Obes Metab Syndr. 2024 Dec 30;33(4):360-366. doi: 10.7570/jomes24002. Epub 2024 Sep 13.
We conducted a study to determine the relationships between perirenal fat (PRF) thickness and urinary levels of monocyte chemoattractant protein-1 (MCP-1) and neutrophil gelatinase-associated lipocalin (NGAL) in patients with hypertension (HTN).
In 338 HTN patients (aged 63.5±12.3 years on average), MCP-1 and NGAL levels were studied using enzyme-linked immunosorbent assay (ELISA). To measure PRF thickness, all patients underwent CT scans.
We considered PRF thickness ≥1.91 cm as the diagnostic threshold for perirenal obesity. Patients with excessive PRF thickness exhibited significantly lower levels of MCP-1 and NGAL compared with those with PRF thickness ≥1.91 cm: 0.98 pg/mL (interquartile range [IQR], 0.21 to 2.05) vs. 2.35 pg/mL (IQR, 0.37 to 5.22) for MCP-1 and 50.0 pg/mL (IQR, 48.9 to 67.8) vs. 98.3 pg/mL (IQR, 68.4 to 187.1) for NGAL. We found a relationship of PRF thickness with both MCP-1 (r=0.46, <0.05) and NGAL (r=0.53, <0.05), the levels of which were significantly different in patients with first- and third-stage chronic kidney disease: 0.33 pg/mL (IQR, 0.21 to 1.35) vs. 4.47 pg/mL (IQR, 0.23 to 10.81); 50.0 pg/mL (IQR, 49.4 to 85.5) vs. 126.45 pg/mL (IQR, 57.5 to 205.15), respectively (=0.04). Patients with metabolically healthy obesity (MHO) had significantly lower MCP-1 levels than those with metabolically unhealthy obesity (MUO): 0.65 pg/mL (IQR, 0.21 to 2.15) vs. 3.28 pg/mL (IQR, 2.05 to 5.22) (=0.014). MHO patients showed significantly lower NGAL levels than MUO patients: 50.0 pg/mL (IQR, 49.4 to 62.2) vs. 98.3 pg/mL (IQR, 50.0 to 174.8) (=0.04). Multiple linear regression analysis revealed significant relationships of MCP-1 with PRF thickness (β±standard error, 0.41±0.15; <0.001) and smoking (0.26±0.13; =0.01) and of NGAL with age (0.45±0.16; <0.01) and PRF thickness (0.49±0.15; <0.001).
We identified higher concentrations of renal fibrosis markers in patients with perirenal and MUO as well as a link between PRF thickness and MCP-1 and NGAL levels in urine.
我们开展了一项研究，以确定高血压（HTN）患者的肾周脂肪（PRF）厚度与尿单核细胞趋化蛋白-1（MCP-1）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平之间的关系。
在338例高血压患者（平均年龄63.5±12.3岁）中，采用酶联免疫吸附测定（ELISA）法研究MCP-1和NGAL水平。为测量PRF厚度，所有患者均接受了CT扫描。
我们将PRF厚度≥1.91 cm视为肾周肥胖的诊断阈值。PRF厚度过大的患者与PRF厚度≥1.91 cm的患者相比，MCP-1和NGAL水平显著更低：MCP-1分别为0.98 pg/mL（四分位间距[IQR]，0.21至2.05）和2.35 pg/mL（IQR，0.37至5.22）；NGAL分别为50.0 pg/mL（IQR，48.9至67.8）和98.3 pg/mL（IQR，68.4至187.1）。我们发现PRF厚度与MCP-1（r = 0.46，P<0.05）和NGAL（r = 0.53，P<0.05）均有关系，在第一期和第三期慢性肾病患者中，其水平存在显著差异：分别为0.33 pg/mL（IQR，0.21至1.35）和4.47 pg/mL（IQR，0.23至1 .81）；50.0 pg/mL（IQR，49.4至85.5）和126.45 pg/mL（IQR，57.5至205.15），P = 0.04。代谢健康肥胖（MHO）患者的MCP-1水平显著低于代谢不健康肥胖（MUO）患者：分别为0.65 pg/mL（IQR，0.21至2.15）和3.28 pg/mL（IQR，2.05至5.22），P = 0.014。MHO患者的NGAL水平显著低于MUO患者：分别为50.0 pg/mL（IQR，49.4至62.2）和98.3 pg/mL（IQR，50.0至174.8），P = 0.04。多元线性回归分析显示，MCP-1与PRF厚度（β±标准误，0.41±0.15；P<0.001）和吸烟（0.26±0.13；P = 0.01）以及NGAL与年龄（0.45±0.16；P<0.01）和PRF厚度（0.49±0.15；P<0.001）均存在显著关系。
我们发现肾周肥胖和代谢不健康肥胖患者的肾纤维化标志物浓度更高，并且PRF厚度与尿中MCP-1和NGAL水平之间存在关联。
