ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2018, Vol. 27 ›› Issue (5): 401-406.DOI: 10.3969/j.issn.1006-298X.2018.05.001

• 论文 •    下一篇

肥胖相关性肾病代谢指标的特点

  

  • 出版日期:2018-10-28 发布日期:2018-11-14

Characteristics of metabolism in patients with obesityrelated glomerulopathy

  • Online:2018-10-28 Published:2018-11-14

摘要:

目的:讨论肥胖相关性肾病(ORG)患者的临床表现、病理特征,关注ORG代谢指标的特点。
方法:根据体质量指数(BMI)分组,回顾性研究2012年5月至2016年5月南京总院国家肾脏疾病临床医学研究中心经肾活检诊断为肥胖相关性肾病的108名患者的临床和病理特征。
结果:ORG患者平均年龄为(372±100)岁,以青年为主,男性占713%。其BMI平均为(313±29) kg/m2,以中度肥胖为主。患者的平均肥胖时间为(127±78)年,中位蛋白尿为14(09~20) g/24h,其中少量、中量、大量蛋白尿分别占287%、620%、93%。此外,74%患者伴肾功能受损,472%有肾小管功能异常。肾活检病理表现均为肾小球肥大,519%患者合并局灶节段性肾小球硬化(FSGS)。750%患者伴高血压,454%伴糖代谢异常,1000%合并血脂异常,602%高尿酸血症,157%发现肾结晶或肾结石。其中,血脂异常以高三酰甘油(TG)血症、低高密度脂蛋白胆固醇(HDLC)血症为主,但总胆固醇、TG、低密度脂蛋白胆固醇(LDLC)、HDLC与BMI无相关性。
结论:ORG发病人群以青年男性为主,主要表现为长期、中度肥胖,少量和中量蛋白尿,可伴肾功能受损和肾小管功能受损,病理上表现为肾小球肥大和(或)FSGS。ORG患者合并多种代谢异常,脂代谢异常最为突出,与BMI无明显相关。

Abstract:

Objective:To analyze the clinical and pathological features in patients with obesityrelated glomerulopathy (ORG) and shed more light on the various metabolic disorders associated with ORG.
Methodology:One hundred and eight patients with ORG were enrolled in this retrospective study,who were diagnosed by renal biopsy in the National Clinical Research Center of Kidney Disease,Nanjing University School of Medicine from May 2012 to May 2016.According to the body mass index (BMI),these subjects were divided into three groups,including mild obesity group (28 kg/m2≤BMI<30 kg/m2),moderate obesity group (30 kg/m2≤BMI<35 kg/m2) and severe obesity group (BMI≥35 kg/m2).
Results:There were 44,54, and 10 patients in mild obesity group,moderate obesity group and severe obesity group,respectively. The average age of ORG patients was(372±100)years,and the majority of them were young and male. The average BMI of them was (313±29) kg/m2 and the most patients were in the moderate obesity group. In this study,the average time of obesity in ORG patients was(127±78)years. The medium proteinuria was 14(09~20) g/24h,and the proportions of minor,medium and massive proteinuria were 287%,620% and 93%,respectively. In addition,74% and 472% patients separately suffered from impaired function of the kidney and renal tubule. The pathological manifestations of ORG were glomerular hypertrophy,and 519% combined with FSGSThe hypertension,abnormal glucose metabolism,dyslipidemia,hyperuricemia and kidney crystals or kidney stones were observed in 750%,454%,1000%,602% and 157%,respectivelyDespite high prevalence of hypertriglyceridemia and hypo high density lipoprotein cholesterolemia,there was no correlation between TC,TG,LDLC,HDLC and BMI.
Conclusion:
ORG was mainly characterized by young male,longterm and moderate obesity,nomassive proteinuria,impaired renal function,impaired renal tubular function and glomerular hypertrophy with (without) FSGS.ORG patients were associated with a variety of metabolic abnormalities,in which abnormal lipid metabolism was the most prominentHowever,it is no obvious correlation between BMI and blood lipid indicators.

Key words: obesity, obesity-related glomerulopathy, metabolic disorder