肥胖,过和早期损伤:一种用于估计肌素清除量的新公式
Alessio Basolo1, Guido Salvetti1, Domenico Giannese2
1Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa 56124, Italy.
The Journal of clinical endocrinology and metabolism
|June 10, 2023
概括
肥胖与脏疾病有关,但标准肌素清除测试在肥胖患者中是不准确的. 一种新的配方提高了准确性,有助于检测过,并防止错过诊断在这个人群中.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 代谢综合征是代谢综合征的一种.
背景情况:
- 肥胖越来越被认为是慢性病的危险因素.
- 淋巴细胞过,脏过率升高,是将肥胖与脏损伤联系起来的潜在机制.
- 估计肌素清除率 (eCrCl) 的现有公式在肥胖个体中缺乏验证.
研究的目的:
- 评估标准eCrCl公式 (Cockroft-Gault,MDRD,CKD-EPI) 与肥胖患者队列中测量的肌素清除率 (mCrCl) 的性能.
- 开发和提出一种新的,更准确的eCrCl配方在肥胖人口中,以帮助早期发现损伤.
主要方法:
- 研究了一组342名患有肥胖症 (平均BMI为47.6公斤/米2),但没有初级脏疾病的患者.
- 进行24小时尿液采集以测量肌素清除率 (mCrCl).
- 标准eCrCl配方的性能与mCrCl进行了比较;一个新的基于CG的配方得到了推导.
主要成果:
- 测量的肌素清除量 (mCrCl) 在肥胖患者中显示出与体重的正相关性.
- 标准公式显示了显著的差异:Cockroft-Gault高估了高CrCl,而CKD-EPI和MDRD低估了它.
- 开发了一种基于CG的新型配方,显示了eCrCl的提高准确性,特别是在BMI截止值32kg/m2以上应用时.
结论:
- 在肥胖患者中,淋巴膜过率随体重增加而增加,并且与早期损伤标志物 (如白膜尿) 相关.
- 拟议的新型配方提高了肥胖患者eCrCl估计的准确性.
- 提高eCrCl准确度对于避免肥胖人口中错过过和随后病的诊断至关重要.
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