The role of obesity in renal injury in patients with metabolic syndrome
Abstract
Overweight (body mass index, BMI = 25–29,9 kg/m2) and obesity (BMI >30 kg/m2) lead to the development of a metabolic syndrome (MS) and related complications. Patients with MS belong to the high-risk group for various forms of coronary heart diseases (CHD), diabetes mellitus and dysmetabolic nephropathy and in same cases develop chronic kidney failure. The direct influence of adipocytokines produced by adipose tissue may induce functional and structural lesions of the kidney. This research analyses the role of adiposity, and hormones produced by adipose tissue in development of kidney diseases in patients with MS. Methods. 70 patients have been examined (54,8% males, 45,2% females), age 52,8 ± 11,8 years with overweight (BMI 25–29,9 kg/m2) or obesity (BMI >30 kg/m2). Anthropometrics data, plasma leptin and adiponectin concentration, glomerular filtration rate (GFR) and the presence of albuminuria were analyzed. Results. Among the examined patients 77% obesity and 23%, overweight. Increased BMI was accompanied by a rise in leptin and increased degree of albuminuria and a decrease in GFR. The concentration of adiponectin declined with increase in BMI and rose with decrease GFR. A statistically significant positive correlation of leptin with the anthropometrics data and negative correlation with kidney functional parameters (GFR and albuminuria) have been found. The results allow us to consider adiposity as a risk factor for nephropathy in MS.
About the Authors
A. A. Kryachkova
Кафедра нефрологии и гемодиализа ММА им. И.М. Сеченова
Russian Federation
Russian Federation
S. A. Savelyeva
Кафедра нефрологии и гемодиализа ММА им. И.М. Сеченова
Russian Federation
Russian Federation
M. G. Gallyamov
МГУ им. М.В. Ломоносова
Russian Federation
Russian Federation
M. V. Shestakova
ФГУ «Эндокринологический научный центр Росмедтехнологий»
Russian Federation
Russian Federation
I. M. Kutiryna
Кафедра нефрологии и гемодиализа ММА им. И.М. Сеченова
Russian Federation
Russian Federation
References
1. Гайнулин Ш.М, Лазебник Л.Б, Дроздов В.Н. Частота повышенного индекса массы тела при проведении целевой диспансеризации по выявлению сердечно-сосудистых заболеваний у населения г. Москвы // Российский кардиологический журнал. 2006. № 3. С. 34.
2. Дедов И.И., Мельниченко Г.А. Ожирение. М.: ООО «Медицинское информационное агентство», 2006. С. 63–73.
3. Никитин Ю.П., Казека Г.Р., Симонова Г.И. Распространенность компонентов метаболического синдрома X в неорганизованной городской популяции (эпидемиологическое исследование) // Кардиология. 2001. №9. С. 37–40.
4. Ройтберг Г.Е. Метаболический синдром. М.: МЕД-пресс-информ, 2007. 224 с.
5. Федорова Е.Ю. Ранние маркеры поражения почек при ожирении: автореф. дис. … канд. мед. наук. М. 2006.
6. Chen J., Gu D., Chen C.S. et al. Association between the metabolic syndrome and chronic kidney disease in Chinese adults. // Nephrol Dial Transplant. 2007. Vol. 22. P. 1100–1106.
7. Chdek J.; Adamczak M.; Nieszporek T. et al. Adipose Tissue as an Endocrine Organ-A Nephrologistists Perspective. Obesity and kidney // Gunter Wolf. 2006. Vol. 151. P. 70–90.
8. Choi H.S., Ryu S.H., Lee K.B. The relationship of microalbuminuria with metabolic syndrome // Nephron Clin Pract. 2006. Vol. 104. P. 85–93.
9. Chen J., Munter P., Lee H. et al. The metabolic Syndrome and Chronic Kidney Disease in U.S. Adults // Ann Intern Med. 2004. Vol. 140. P. 167–174.
10. International Diabetes Federation / Worldwide definition of the metabolic syndrome. At: http: www/idf.org/webdata/docs/IDF_Metasyndrome_definition.pdf. Accessed August 24, 2005.
11. Kitiyakara C., Yamwong S., Cheepudomwit S. et al. The metabolic syndrome and chronic kidney disease in a Southeast Asian cohort // Kidney Int. 2007. Vol. 71: P. 693–700.
12. Ninomiya T., Kiyohara Y., Kubo M. et al. Metabolic syndrome and CKD in a general Japanese population: The Hisayama Study //Am J Kidney Dis. 2006. Vol. 48. Р. 383–391.
13. Papafragkaki D.-K., George T. Obesity and renal disease: A possible role of leptin // HORMONES. 2005. Vol. 4 (2). Р. 90–95.
14. Sharma K., Ramachandra R., Gang Q. et al. Adiponectin regulates albuminuria and podocyte function in mice // J Clin. Invest. 2008. Vol. 118. P 1645–1656.
15. Ritz E. Metabolic Syndrome and Kidney Disease // Blood Purif. 2008. Vol. 26. P. 59–62.
16. Tasaka Y., Yanagisawa K., Iwamoto Y. Human plasma leptin in obese subjects and diabetics // Endocr J. 1997. Vol. 44. P. 671–676.
17. Vettor R., De Pergola G. et al. Gender differences in serum leptin in obese people: relationship with testosterone, body fat distribution and insulin sensitivity // Eur J Clin Invest. 1997. Vol. 27. P. 1016–1024.
18. Yoshihisa O., Shiniji K., Tohru F. et al. Adiponectin: a key adipocytokine in metabolic syndrome //Clinical Science. 2006. Vol. 110. P. 267–278.
19. Yomomoto Y., Hirose H., Saito I. et al. Adiponectin an adipocyte-derived protein, predicts future insulin resistance: two-year follow-up study in Japanese population // J. Clin. Endocrinol. Metab. 2004. Vol. 89. Р. 87–90.
Review
For citations:
Kryachkova A.A., Savelyeva S.A., Gallyamov M.G., Shestakova M.V., Kutiryna I.M. The role of obesity in renal injury in patients with metabolic syndrome. Nephrology and Dialysis. 2010;12(1):034-038. (In Russ.)
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