儿童青少年单纯性肥胖早期肾损害独立相关 因素研究

A Study on Independent Risk Factors for Early Renal Damage in Children and Adolescents with Simple Obesity

摘要: 目的：探讨儿童青少年单纯性肥胖早期肾损害的独立相关因素及预测价值。方法：收集2022年1月至2024年8月青岛大学附属医院儿童内分泌代谢科诊断的6~15岁单纯性肥胖儿童青少年共249例为研究对象，同期年龄相仿的健康儿童青少年共98例为对照组，应用回顾性对照研究。留取人群临床资料，包括一般资料、血液及尿液检查结果。根据尿微量白蛋白/尿肌酐(UACR)水平分为：UACR异常肥胖组、UACR正常肥胖组及对照组，比较三组一般临床资料、实验室检查参数的差异性。采用多变量Logistic回归分析找出肾脏损害的预测指标；并通过ROC曲线分析各指标早期肾损害预测价值。结果：肥胖持续时间、DBP-SDS、血清Cys-C、TG在UACR异常肥胖组、UACR正常肥胖组与对照组间存在统计学差异。肥胖持续时间、DBP-SDS、TG、血清Cys-C是儿童青少年单纯性肥胖早期肾损害的独立相关因素。结论：肥胖持续时间、腰高比、体质指数、血压、血清Cys-C、血脂、胰岛素抵抗指数与儿童青少年单纯性肥胖早期肾损害相关；肥胖持续时间、DBP-SDS、血清Cys-C、TG是儿童青少年单纯性肥胖早期肾损害的独立相关因素，其中二者联合检测优于单项检测。

Abstract: Objective: To investigate the independent risk factors and predictive value of early renal damage in children and adolescents with simple obesity. Methods: A total of 249 children and adolescents aged 6~15 years diagnosed with simple obesity at the Department of Pediatric Endocrinology, Metabolism and Gastroenterology, The Affiliated Hospital of Qingdao University, between January 2022 and August 2024, were enrolled as the study group. A total of 98 healthy children and adolescents of similar age from the same period served as the control group. A retrospective case-control study was conducted. Clinical data were collected, including general demographics and results of blood and urine tests. Participants were categorized into three groups based on urinary microalbumin-to-creatinine ratio (UACR) levels: the UACR-abnormal obesity group, the UACR-normal obesity group, and the control group. Differences in general clinical data and laboratory parameters were compared across the three groups. Multivariate Logistic regression analysis was performed to identify predictive indicators of renal damage, and ROC curve analysis was conducted to assess the predictive value of each indicator for early renal damage. Results: Duration of obesity, DBP-SDS, serum Cys-C and TG showed statistically significant differences between the UACR-abnormal obesity group, the UACR-normal obesity group and the control group. Duration of obesity, DBP-SDS, TG and serum Cys-C were identified as independent risk factors for early renal damage in children and adolescents with simple obesity. Conclusion: Duration of obesity, waist-to-height ratio, body mass index, blood pressure, serum Cys-C, blood lipids and insulin resistance index are associated with early renal damage in children and adolescents with simple obesity; duration of obesity, DBP-SDS, serum Cys-C and TG are independent risk factors for early renal damage in children and adolescents with simple obesity, with combined testing of these two factors proving superior to individual testing.