单纯性肥胖对儿童肾功能的影响

Influence of Simple Obesity on Kidney Function in Children

目的探讨单纯性肥胖对儿童早期肾功能的影响及其发生机制。方法选择70例单纯性肥胖患儿为单纯性肥胖组,50例健康儿童为健康对照组,测量二组儿童身高和体质量,计算体质量指数(BMI);采用放射免疫法检测二组儿童24h尿微量清蛋白(Alb)、β2微球蛋白(β2-MG)和α1微球蛋白(α1-MG)水平,采用SAS8.0软件比较二组BMI、24h尿Alb、β2-MG及α1-MG的差异,分析二组BMI与24h尿Alb的相关性。结果单纯性肥胖组BMI、24h尿Alb水平均显著高于健康对照组(t=15.14,P<0.001;t=4.084,P<0.001),单纯性肥胖组尿β2-MG及α1-MG水平与健康对照组比较差异均无统计学意义(t=1.847,P>0.05;t=1.936,P>0.05),单纯性肥胖组BMI与24h尿Alb水平呈显著正相关(r=0.626,P<0.01)。结论儿童单纯性肥胖可致肾功能损伤,早期主要表现为肾小球功能受损,尿Alb可作为评价单纯性肥胖患儿早期肾功能损害的指标之一,单纯性肥胖患儿肾功能损害程度与肥胖程度有关。

Objective To study the influence of simple obesity on kidney function in children and to explore the mechanism of early renal function change.Methods Seventy cases of simple obesity children were chosen as simple obesity group,50 cases of healthy children as healthy control group.The height and weight of all cases were measured and their body mass index（BMI） were calculated.The contents of 24 hours urinary microdose albumin （Alb）,β2-microglobulin （β2-MG） and α1-microglobulin （α1-MG） were tested by radioimmunoassay.The differences between simple obesity group and healthy control group were analyzed,including BMI,urinary 24 h-Alb,β2-MG,and α1-MG.The correlation of BMI with urinary 24 h-Alb was analyzed by SAS 8.0 software.Results The levels of BMI and urinary 24 h-Alb in simple obesity group were significantly higher than those in healthy control group（t=15.14,P0.001;t=4.084,P0.001）.There was no significant difference of β2-MG and α1-MG contents between simple obesity group and healthy control group （t=1.847,P0.05;t=1.936,P0.05）.In simple obesity group,there was positive correlation between BMI and urinary 24 h-Alb content（r=0.626,P0.01）.Conclusions Simple obesity in children can induce renal damage.Main manifestation is glomerulus dysfunction in early stage.Urinary Alb can be one indicators of early kidney damage in simple obesity children. The degree of kidney dysfunction is related to the degree of obesity.