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单纯性肥胖儿童青少年早期肾损伤的新标志物。

New Markers of Early Kidney Damage in Children and Adolescents with Simple Obesity.

机构信息

Clinical Department of Paediatric Nephrology, Wroclaw Medical University, 50-367 Wrocław, Poland.

Clinical Department of Paediatrics, Endocrinology, Diabetology and Metabolic Diseases, Wroclaw Medical University, 50-367 Wrocław, Poland.

出版信息

Int J Mol Sci. 2024 Oct 7;25(19):10769. doi: 10.3390/ijms251910769.

Abstract

The impact of obesity on kidney injury and the development of chronic kidney disease (CKD) is well documented. Unfortunately, the early stages of CKD are asymptomatic, leading to a delayed diagnosis and a worse prognosis. There is a need for more sensitive indicators of kidney damage than those currently used. We aimed to assess the usefulness of serum t-CAF, urinary netrin-1, α-GST, π-GST, calbindin, and calprotectin as biomarkers of early kidney damage in obese children and to investigate the relationship between these indicators and the degree of obesity. A total of 125 simple obese, normoalbuminuric children and 33 non-obese children as controls were selected. Patients were divided into 2 subgroups according to SDS BMI (I: 2 ≤ 4, II: >4). Serum t-CAF was significantly higher in the obese group compared to the controls, as were urinary α-GST, netrin-1, π-GST, and calprotectin. No difference was found between the two obese groups. In normoalbuminuric obese children and adolescents without significant metabolic disorders, serum t-CAF may be a new biomarker for the early detection of renal dysfunction, and urinary netrin-1, α-GST, π-GST, and calprotectin may be better indicators for the detection of early tubular damage, independent of the severity of obesity.

摘要

肥胖对肾脏损伤和慢性肾脏病(CKD)发展的影响已有充分的文献记载。不幸的是,CKD 的早期阶段没有症状,导致诊断延迟和预后更差。需要有比目前使用的更敏感的肾脏损伤指标。我们旨在评估血清 t-CAF、尿 netrin-1、α-GST、π-GST、钙结合蛋白和钙卫蛋白作为肥胖儿童早期肾脏损伤生物标志物的有用性,并研究这些指标与肥胖程度的关系。共选择了 125 例单纯肥胖、正常白蛋白尿儿童和 33 名非肥胖儿童作为对照组。根据 SDS BMI(I:2 ≤ 4,II:>4)将患者分为 2 个亚组。与对照组相比,肥胖组血清 t-CAF 显著升高,尿 α-GST、netrin-1、π-GST 和 calprotectin 也升高。两个肥胖组之间没有差异。在没有明显代谢紊乱的正常白蛋白尿肥胖儿童和青少年中,血清 t-CAF 可能是早期发现肾功能障碍的新生物标志物,尿 netrin-1、α-GST、π-GST 和 calprotectin 可能是检测早期肾小管损伤的更好指标,与肥胖程度无关。

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1
Childhood Obesity: Insight into Kidney Involvement.儿童肥胖症:对肾脏受累的深入了解。
Int J Mol Sci. 2023 Dec 12;24(24):17400. doi: 10.3390/ijms242417400.
2
Calprotectin: two sides of the same coin.钙卫蛋白:一枚硬币的两面。
Rheumatology (Oxford). 2024 Jan 4;63(1):26-33. doi: 10.1093/rheumatology/kead405.
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Which Patients with Obesity Are at Risk for Renal Disease?哪些肥胖患者有患肾病的风险?
Nephron. 2021;145(6):595-603. doi: 10.1159/000513868. Epub 2021 Mar 5.
9
Microalbuminuria and Serum Cystatin C: Biomarkers for Early Detection of Kidney Injury in Children with Obesity.
Indian J Pediatr. 2020 Dec;87(12):991-992. doi: 10.1007/s12098-020-03526-2. Epub 2020 Oct 13.

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