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2 型糖尿病患者肾周脂肪厚度与肾小球滤过率降低的关系。

The Relationship between Perirenal Fat Thickness and Reduced Glomerular Filtration Rate in Patients with Type 2 Diabetes.

机构信息

Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China.

Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149, China.

出版信息

J Diabetes Res. 2020 Jun 28;2020:6076145. doi: 10.1155/2020/6076145. eCollection 2020.

Abstract

BACKGROUND

Obesity has been considered as an important factor in the development and progression of chronic kidney diseases (CKD). Perirenal fat, which is surrounding the kidneys, has been reported to be unique in anatomy and biological functions. This study is aimed at assessing the relationship between perirenal fat thickness (PrFT) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes (T2DM).

METHODS

A total of 171 patients with T2DM were recruited in the study. The basic and clinical characteristics including sex, age, diabetes duration, body mass index (BMI), waist circumference (WC), visceral fat area (VFA), glycated hemoglobin (HbA1c), serum uric acid (UA), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) were collected. PrFT was measured via ultrasound. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) formula.

RESULTS

Patients were divided into three groups according to PrFT, and we found patients with higher PrFT had lower eGFR. PrFT was significantly correlated with eGFR in all patients ( = -0.181, < 0.05). Subgroup analysis by sex showed that PrFT still significantly and negatively related to eGFR in men ( = -0.264, < 0.05), but not in women ( = -0.199, = 0.062). The association also existed in multivariate analysis after correction for the confounding factors ( = -0.203, = 0.017).

CONCLUSIONS

This study confirmed a negative independent relationship between PrFT and eGFR in patients with T2DM, especially in men, suggesting a possible role of perirenal fat in kidney dysfunction in T2DM patients.

摘要

背景

肥胖被认为是慢性肾脏病(CKD)发展和进展的一个重要因素。肾周脂肪是围绕肾脏的脂肪,其解剖结构和生物学功能具有独特性。本研究旨在评估 2 型糖尿病(T2DM)患者肾周脂肪厚度(PrFT)与估算肾小球滤过率(eGFR)之间的关系。

方法

本研究共纳入 171 例 T2DM 患者。收集患者的基本临床特征,包括性别、年龄、糖尿病病程、体重指数(BMI)、腰围(WC)、内脏脂肪面积(VFA)、糖化血红蛋白(HbA1c)、血尿酸(UA)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)和高密度脂蛋白胆固醇(HDL-c)。采用超声测量 PrFT,应用改良肾脏病膳食研究(MDRD)公式计算 eGFR。

结果

根据 PrFT 将患者分为三组,发现 PrFT 较高的患者 eGFR 较低。所有患者的 PrFT 与 eGFR 均呈显著负相关( = -0.181, < 0.05)。按性别进行亚组分析,发现男性患者 PrFT 与 eGFR 仍呈显著负相关( = -0.264, < 0.05),而女性患者无此相关性( = -0.199, = 0.062)。校正混杂因素后,多元分析仍显示两者存在相关性( = -0.203, = 0.017)。

结论

本研究证实 T2DM 患者 PrFT 与 eGFR 呈负相关,且相关性独立,尤其在男性患者中更为明显,提示肾周脂肪可能在 T2DM 患者肾功能障碍中起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a503/7341433/10e6fcb30181/JDR2020-6076145.001.jpg

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