上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2017, Vol. 37 ›› Issue (9): 1213-.doi: 10.3969/j.issn.1674-8115.2017.09.005

• 论著（基础研究） • 上一篇    下一篇

中国中老年社区人群肥胖与慢性肾脏疾病的相关性研究

吴雪妍 *，程棣 *，马丽娜，林琳，杜瑞，徐瑜，徐敏，毕宇芳，王卫庆，陆洁莉   

  1. 上海市内分泌代谢病临床医学中心，上海市内分泌代谢病研究所，上海交通大学 医学院附属瑞金医院内分泌代谢病科，上海 200025
  • 出版日期:2017-09-28 发布日期:2017-10-10
  • 通讯作者: 陆洁莉，电子信箱：jielilu@hotmail.com
  • 作者简介:吴雪妍（1992—），女，硕士生；电子信箱：pidaifu0302@163.com。程 棣（1991—），女，硕士生；电子信箱：fiascocd@qq.com。* 为共同第一作者
  • 基金资助:
    国家自然科学基金（81370960）；国家科技支撑计划（2015BAI12B02）；上海市教育委员会曙光计划（15SG15）；上海市教育委员会高峰高原学科 建设计划（20152202）

Association between obesity and chronic kidney disease among a middle-aged and elderly Chinese community population#br#

WU Xue-yan*, CHENG Di*, MA Li-na, LIN Lin, DU Rui, XU Yu, XU Min, BI Yu-fang, WANG Wei-qing, LU Jie-li   

  1. Shanghai Clinical Medicine Center for Endocrine and Metabolic Diseases; Shanghai Institute of Endocrine and Metabolic Diseases; Department of Endocrinology and Metabolism, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2017-09-28 Published:2017-10-10
  • Supported by:
    National Natural Science Foundation of China, 81370960; National Science and Technology Support Program, 2015BAI12B02; Dawn Program of Shanghai Education Commission, 15SG15; Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152202

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摘要： 目的 · 研究中国中老年社区人群肥胖与慢性肾脏疾病（CKD）的相关性。方法 · 采取整群抽样的方法对上海市嘉定区 10 375 名 40 岁及以上的常住居民进行调查。每位受试者均接受标准化问卷调查、体格检查，同时采集空腹血和晨尿标本检测血糖、血脂、 肝功能、肾功能、尿白蛋白、尿肌酐等生化指标。肥胖程度的判断采用世界卫生组织（WHO）的诊断标准，将男性和女性按照体质量 指数（BMI）分为正常体质量组（BMI<25 kg/m2）、超重组（25 kg/m2 ≤ BMI<30 kg/m2）、肥胖组（BMI ≥ 30 kg/m2）。依据美国 CKD 流行病学合作研究组（CKD-EPI）方程计算获得估算的肾小球滤过率。采用Logistic 回归分析不同BMI 水平人群CKD 的患病风险。
 结果 · 研究对象各项代谢指标均随着 BMI 水平的升高而趋向恶化。在校正多种因素后，BMI 每增加 1 kg/m2，CKD 患病风险增加 9%， 其比值比（OR）为 1.09（95% CI：1.07 ～ 1.12）。多元 Logistic 回归分析结果显示，超重组和肥胖组的 CKD 患病风险较正常体质量组 分别增加 51%（OR=1.51, 95% CI：1.27 ～ 1.78）和 181%（OR=2.81, 95%CI：2.20 ～ 3.61）。 结论 · 在中国中老年社区人群中，超重和 肥胖者 CKD 患病风险显著升高。

关键词: 慢性肾脏疾病, 肥胖, 超重, 体质量指数, 中老年人群

Abstract:

 Objective · To investigate the relationship between obesity and chronic kidney disease (CKD) in a community-based study among a middle-aged and elderly Chinese population.  Methods · A survey of 10 375 inhabitants aged 40 years or older in Jiading District of Shanghai was performed using cluster sampling. All the subjects were recruited to undergo questionnaire interview, anthropometric measurements, and biochemical measurements. Blood and urine samples were collected to measure biochemical features, including plasma glucose, lipid profiles, liver and renal function, as well as urinary albumin and creatinine. Obesity status was diagnosed according to the World Health Organization (WHO) criteria. According to body mass index (BMI) levels, the subjects were divided into normal weight group (BMI<25 kg/m2), overweight group
 (25 kg/m2 ≤ BMI<30 kg/m2) and obesity group (BMI ≥ 30 kg/m2). The estimated glomerular filtration rate (eGFR) was calculated based on American Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Logistic regression analysis was used to analyze the risk of CKD among people with different BMI levels.  Results · Increased BMI levels were associated with more unfavorable metabolic profiles. After a variety of factors were adjusted, each 1 kg/m2 increment of BMI was associated with a 9% higher risk of prevalent CKD, and the odds ratio (OR) was 1.09 (95% CI：1.07-1.12). Results from multivariate Logistic regression analysis showed that in the total population, compared with individuals in the normal weight group, those in the overweight and obesity groups had 51% (OR=1.51, 95% CI: 1.27-1.78) and 181% (OR=2.81, 95% CI: 2.20-3.61) higher risk of prevalent CKD.  Conclusion · In the middle-aged and elderly community population in China, overweight and obesity are associated with an increased risk of prevalent CKD.

Key words: chronic kidney disease, obesity, overweight, body mass index, middle-aged and elderly population