肾移植患者尿酸与身体脂肪和生化指标的关系

IF 2.9 Q3 NUTRITION & DIETETICS Clinical nutrition ESPEN Pub Date : 2024-09-12 DOI:10.1016/j.clnesp.2024.09.007
Thamiris S. Vieira, Larissa S. Limirio, Erick P. de Oliveira
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引用次数: 0

摘要

背景:在肾功能正常的人群中,肥胖和各种生化指标(包括甘油三酯、胆固醇、葡萄糖、C 反应蛋白和肾小球滤过率)与尿酸(UA)水平升高有关,原因是尿酸排泄减少和/或尿酸合成增加。然而,在肾功能受损的临床人群中,如肾移植患者(KTPs),所有这些因素是否与尿酸水平有类似的关联仍不清楚:评估肾移植患者的血清尿酸水平是否与身体脂肪含量和生化指标相关:方法:对113名肾移植患者进行横断面研究。使用生物电阻抗估算体脂,并使用无弹性胶带测量腰围。使用比色法测量血清中的尿酸、肌酐、葡萄糖、甘油三酯、总胆固醇及其组分。C 反应蛋白水平采用免疫比浊法评估,尿素水平通过酶动力学测定。肾小球滤过率采用慢性肾脏病流行病学协作方程进行估算。采用线性回归分析评估血清尿酸水平与身体脂肪以及生化参数之间的关系,同时对混杂因素进行调整:血清尿酸水平与肌酐(β = 0.402; p = 0.013)和尿素(β = 0.024; p = 0.001)呈正相关,而与肾小球滤过率(β = -0.030; p < 0.001)呈负相关。然而,血清尿酸水平与脂肪量(千克和百分比)、腰围、甘油三酯、C 反应蛋白、血糖、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、超低密度脂蛋白胆固醇或总胆固醇没有明显关联:结论:血清尿酸水平仅与肾功能相关的生化指标有关。因此,在肾功能欠佳的人群(如 KTPs)中,尿酸与其他生化指标和身体肥胖并不相关,这在非肾脏疾病人群中很常见。
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Association of uric acid with body adiposity and biochemical parameters in kidney transplant patients

Background

Obesity and various biochemical parameters, including triglycerides, cholesterol, glucose, C-reactive protein, and estimated glomerular filtration rate, have been linked to elevated uric acid (UA) levels in populations with normal kidney function due to decreased UA excretion and/or increased UA synthesis. However, it remains unclear whether all these factors exhibit similar associations with UA levels in clinical populations characterized by compromised renal function, such as kidney transplant patients (KTPs).

Objective

To evaluate whether serum UA levels are associated with body adiposity and biochemical parameters in KTPs.

Methods

A cross-sectional study involving 113 KTPs was conducted. Body fat was estimated using bioelectrical impedance, and waist circumference was measured using an inelastic tape. Serum levels of UA, creatinine, glucose, triglycerides, total cholesterol, and its fractions were measured using the colorimetric method. C-reactive protein levels were assessed using the immunoturbidimetric method, and urea levels were determined via enzymatic kinetics. Glomerular filtration rate was estimated using the chronic kidney disease epidemiology collaboration equation. Linear regression analyses were employed to assess the association between serum UA levels and body adiposity as well as biochemical parameters, while adjusting for confounders.

Results

Serum UA levels exhibited a positive association with creatinine (β = 0.402; p = 0.013) and urea (β = 0.024; p = 0.001), while demonstrating an inverse association with estimated glomerular filtration rate (β = −0.030; p < 0.001). However, serum UA levels were not significantly associated with fat mass (both in kilograms and as a percentage), waist circumference, triglycerides, C-reactive protein, glucose, HDL cholesterol, LDL cholesterol, VLDL cholesterol, or total cholesterol.

Conclusion

Serum UA levels are only associated with biochemical parameters linked to renal function in KTPs. Consequently, in individuals with suboptimal renal function, such as KTPs, UA does not exhibit associations with other biochemical parameters and body adiposity, as commonly observed in non-renal disease populations.
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来源期刊
Clinical nutrition ESPEN
Clinical nutrition ESPEN NUTRITION & DIETETICS-
CiteScore
4.90
自引率
3.30%
发文量
512
期刊介绍: Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.
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