Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mas...Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.展开更多
目的:观察利拉鲁肽对初诊肥胖2型糖尿病患者腰围和胰岛功能的影响。方法:选取体重指数(body mass index,BMI)≥28 kg/m^2初诊2型糖尿病患者38例,应用利拉鲁肽注射液治疗24周,比较治疗前后患者的空腹血糖(fasting blood glucose,FBG),餐...目的:观察利拉鲁肽对初诊肥胖2型糖尿病患者腰围和胰岛功能的影响。方法:选取体重指数(body mass index,BMI)≥28 kg/m^2初诊2型糖尿病患者38例,应用利拉鲁肽注射液治疗24周,比较治疗前后患者的空腹血糖(fasting blood glucose,FBG),餐后2 h血糖(2 h blood glucose,2h PG)、糖化血红蛋白(hemoglobin a1c,Hb Alc)、甘油三酯(triacylglyceride,TG)、低密度脂蛋白(low density lipoprotein cholesterol,L-DLC)、BMI、腰围(waist circumference,WC)、空腹胰岛素(fasting insulin,FIns)、胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,HOMA-IR)、胰岛素敏感指数(homeostasis model assessment index ofβcell,HOMA-β)。结果:与治疗前比较,患者的FBG、Hb A1c、TG、BMI、HOMA-IR均下降(P<0.05)。治疗后的HOMA-β与治疗前相比升高(P<0.05)。结论:对初诊肥胖的2型糖尿病患者,利拉鲁肽能够有效控制血糖、减小腰围、减轻胰岛素抵抗、提高胰岛素敏感性、改善胰岛β细胞功能。展开更多
文摘Background: Obesity is associated with higher end-stage renal disease incidence, but associations with earlier forms of kidney disease remain incompletely characterized. Methods: We studied the association of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with rapid kidney function decline and incident chronic kidney disease in 4573 non-diabetic adults with eGFR ≥ 60 ml/min/1.73m2 at baseline from longitudinal Multi-Ethnic Study of Atherosclerosis cohort. Kidney function was estimated by creatinine and cystatin C. Multivariate analysis was adjusted for age, race, baseline eGFR, and hypertension. Results: Mean age was 60 years old, BMI 28 kg/m2, baseline eGFRCr 82 and eGFRCys 95 ml/min/1.73m2. Over 5 years of follow up, 25% experienced rapid decline in renal function by eGFRCr and 22% by eGFRCys. Incident chronic kidney disease (CKD) developed in 3.3% by eGFRCys, 11% by eGFRCr, and 2.4% by both makers. Compared to persons with BMI 25, overweight (BMI 25 - 30) persons had the?lowest risk of rapid decline by eGFRCr (0.84, 0.71 - 0.99). In contrast, higher BMI categories were associated with stepwise higher odds of rapid decline by eGFRCys, but remained significant only when BMI ≥ 35 kg/m2 (1.87, 1.41 - 2.48). Associations of BMI with incident CKD were insignificant after adjustment. Large WC and WHR were associated with increased risk of rapid decline only by eGFRCys, and of incident CKD only when defined by both filtration markers. Conclusions: Obesity may be a risk factor for kidney function decline, but associations vary by filtration marker used.
文摘目的:观察利拉鲁肽对初诊肥胖2型糖尿病患者腰围和胰岛功能的影响。方法:选取体重指数(body mass index,BMI)≥28 kg/m^2初诊2型糖尿病患者38例,应用利拉鲁肽注射液治疗24周,比较治疗前后患者的空腹血糖(fasting blood glucose,FBG),餐后2 h血糖(2 h blood glucose,2h PG)、糖化血红蛋白(hemoglobin a1c,Hb Alc)、甘油三酯(triacylglyceride,TG)、低密度脂蛋白(low density lipoprotein cholesterol,L-DLC)、BMI、腰围(waist circumference,WC)、空腹胰岛素(fasting insulin,FIns)、胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,HOMA-IR)、胰岛素敏感指数(homeostasis model assessment index ofβcell,HOMA-β)。结果:与治疗前比较,患者的FBG、Hb A1c、TG、BMI、HOMA-IR均下降(P<0.05)。治疗后的HOMA-β与治疗前相比升高(P<0.05)。结论:对初诊肥胖的2型糖尿病患者,利拉鲁肽能够有效控制血糖、减小腰围、减轻胰岛素抵抗、提高胰岛素敏感性、改善胰岛β细胞功能。
