肥胖、慢性肾病和贫血之间存在性别差异吗

K. Atanassova, J. Masin‐Spasovska, G. Spasovski, E. Paskalev
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摘要

摘要介绍。如今,无论是在经济发达国家还是在欠发达国家,肥胖都已成为慢性肾脏疾病(CKD)最独立的危险因素之一。由于肥胖相关的肾脏疾病(如糖尿病和高血压)而需要透析的患者数量在世界范围内正在增加。此外,肥胖已被证明有利于心血管疾病(CVD)与CKD和/或终末期肾脏疾病(ESRD)引起的过早死亡的风险。本研究旨在探讨慢性肾病患者的肥胖(如体重指数(BMI))、肾功能(如肾小球滤过率(GFR))和肾性贫血之间的关系。方法。回顾性分析了2013年1月1日至2013年6月30日期间315名不同阶段未使用促红细胞生成刺激剂(ESAs)的透析前CKD患者的登记数据,以评估CKD损害程度与肥胖和贫血程度之间的关系。通过GFR计算CKD的分期和/或进展,而通过体重指数(BMI)计算肥胖程度。CKD定义为肾小球滤过率(GFR) < 60ml /min / 1.73 m2。通过简单的Microsoft excel程序进行数据分析。结果。315例CKD患者中,男性123例,平均年龄63.4±1.33岁,女性192例,平均年龄57.3±1.2岁。GFR随BMI升高而降低,大多数患者(n=243)处于CKD 3期,平均GFR为44.5 ml/min/1.73 m2。女性一、二级肥胖患者的BMI值与GFR呈负相关(r= - 0.46, p<0.05)。只有女性二度肥胖患者(BMI为35-39.9 kg/m2)的肾功能下降与Hb水平降低呈正相关。结论。我们的研究不仅为肥胖程度(BMI)与肾功能损害程度(GFR)之间存在关联提供了无条件的证据,而且还为二级肥胖女性中较高的BMI与较高的肾性贫血程度之间存在关联提供了无条件的证据。需要进一步的大规模试验和介入性研究来观察体重减轻对肾功能的影响,特别是对贫血的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is there any Gender Difference in the Association between Obesity, Chronic Kidney Disease and Anemia
Abstract Introduction. Nowadays, obesity has emerged as one of the most independent risk factors for chronic kidney disease (CKD) in both economically developed and undeveloped countries. The number of patients requiring dialysis as a consequence of obesity-related renal diseases, such as diabetes mellitus and hypertension, is increasing worldwide. Moreover, obesity has been shown to favorize the risk of cardiovascular diseases (CVD) with premature death due to CKD and/or end-stage renal disease (ESRD). The aim of the study was to investigate the association between obesity [e.g. body mass index (BMI)], kidney function [e.g. glomerular filtration rate (GFR)] and renal anemia in CKD patients. Methods. Retrospectively, data from the register of 315 pre-dialysis patients with different stages of CKD not on erythropoiesis stimulation agents (ESAs) during the period between 1 Jan 2013-30 June 2013 were used to assess the association between the degree of CKD impairment with the degree of obesity and anemia. The stage and/or progression of CKD was calculated by GFR, while the degree of obesity by the body mass index (BMI). CKD was defined as a glomerular filtration rate (GFR) <60 mL/min per 1.73 m2. Data analysis was performed by means of the simple Microsoft excel program. Results. Within the study population of 315 CKD patients, 123 were males with mean age of 63.4±1.33 years and 192 females of 57.3±1.2 years. The GFR reduced with the increased BMI in both genders, and majority of patients (n=243) were in CKD stage 3, with a mean GFR of 44.5 ml/min/1.73 m2. The BMI values in female patients with first and second degree of obesity negatively correlated with GFR (r=−0.46, p<0.05). Only female patients with second degree of obesity (BMI of 35-39.9 kg/m2) had a positive correlation between the decreased renal function and reduced Hb levels. Conclusions. Our study provided an unconditional evidence not only for the presence of an association between the degree of obesity (BMI) and the degree of renal function impairment (GFR), but also an association between the higher BMI and the higher degree of kidney anemia seen in women with second degree of obesity. Further larger scale trials and interventional studies are required to see the effect of body weight reduction on renal function and especially anemia.
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