Cui Zhengjiu, Chen Xiaorui, Zhai Siming, Luo Fei, Wang Yuanyuan, Hu Chanchan, Yuan Bin
Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of Pediatrics, Suqian Affiliated Hospital of Nanjing University of Chinese Medicine, Suqian, China.
Sci Rep. 2025 Apr 26;15(1):14588. doi: 10.1038/s41598-025-99594-5.
Childhood and adolescent obesity has become one of the most serious public health problems worldwide, and obesity may have potential effects on kidney health. The urinary albumin creatinine ratio (UACR) is a sensitive indicator for assessing renal impairment. Relevant studies on pediatric and adolescent populations are more limited and controversial. This study aimed to clarify the relationship between UACR and overweight/obesity in children and adolescents in the United States, thereby providing new insights and recommendations for the clinical management and prevention of kidney disease. This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2016. Variables were derived from demographic, examination, and laboratory data. Overweight/obesity status was assessed using BMI criteria, and random urine samples were used to measure UACR. The association between UACR and overweight/obesity was assessed using descriptive statistics, multivariate logistic regression analysis, subgroup analysis, and curve-fitting analysis. In this study of 4116 participants aged 8-19, multivariate logistic regression analysis revealed a significant negative association between UACR and overweight/obesity (OR = 0.32; 95% CI 0.26-0.38; P < 0.001). The interaction P-values were all greater than 0.05 in the interaction of subgroups, indicating that the findings were very stable and consistent between subgroups. In addition, smoothed curve fitting and threshold effect analyses revealed a nonlinear relationship between UACR and overweight/obesity, with an inflection point for log(UACR) determined to be 1.435 mg/g. The findings suggest a significant nonlinear negative correlation between UACR and overweight/obesity in the pediatric and adolescent populations. Until a precise mechanism of association is found, maintaining a standard range of BMI in all age groups may reduce the incidence of albuminuria in this population.
儿童和青少年肥胖已成为全球最严重的公共卫生问题之一，肥胖可能对肾脏健康产生潜在影响。尿白蛋白肌酐比值（UACR）是评估肾功能损害的敏感指标。关于儿童和青少年人群的相关研究较为有限且存在争议。本研究旨在阐明美国儿童和青少年中UACR与超重/肥胖之间的关系，从而为肾脏疾病的临床管理和预防提供新的见解和建议。本研究利用了2011年至2016年美国国家健康与营养检查调查（NHANES）的数据。变量来自人口统计学、体格检查和实验室数据。使用BMI标准评估超重/肥胖状态，并采集随机尿样测量UACR。采用描述性统计、多因素逻辑回归分析、亚组分析和曲线拟合分析评估UACR与超重/肥胖之间的关联。在这项针对4116名8至19岁参与者的研究中，多因素逻辑回归分析显示UACR与超重/肥胖之间存在显著的负相关（OR = 0.32；95% CI 0.26 - 0.38；P < 0.001）。亚组间交互作用的P值均大于0.05，表明研究结果在亚组间非常稳定且一致。此外，平滑曲线拟合和阈值效应分析显示UACR与超重/肥胖之间存在非线性关系，log（UACR）的拐点确定为1.435 mg/g。研究结果表明，儿童和青少年人群中UACR与超重/肥胖之间存在显著的非线性负相关。在找到确切的关联机制之前，在所有年龄组维持标准的BMI范围可能会降低该人群中蛋白尿的发生率。
