체질량 지수 25 이상의 과체중군에서 신장질환과 관련된 인자들에 대한 연구
Research Related to Chronic Kidney Disease in BMI >25 Overweight Children
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목 적 : 비만은 이제 전 세계적인 보건 문제 중의 하나로서 고혈압과 당뇨를 통해 만성 신장 질환 그리고 말기 신부전을 매개한다는 것은 이미 잘 알려진 사실이다. 본 연구에서는 현미경적 혈뇨 또는 단백뇨를 보여 본원에 내원하여 신생검을 시행한 초기 만성 신질환 환아 중 체질량 지수 25 이상 되는 과체중군에서 신장 질환의 위험도를 증가시키고 신기능 악화 인자로 작용할 수 있는 임상인자들에 대해 정상 체중군의 신질환 환아들과 비교 분석하였다. 방 법 : 2003년 1월부터 2007년 12월까지 지난 5년간 경희대학교 소아청소년과에 지속적인 혈뇨 또는 단백뇨 동반을 주소로 신생검을 시행한 4-18세의 소아 및 청소년 가운데 체질량 지수가 25 이상인 과체중군 26명(남:여=19:7)과 정상 체중의 대조군 49명(남:여=35:14), 총 75명(남:여=54:21)을 대상으로 신체 계측하고, 24시간 요 검사 및 일반 혈액학, 생화학 검사를 측정하였다. 결 론 : 본 연구에서 신질환의 진행과 악화, 심혈관계 합병증, 지방간의 진행과 관계있는 인자들이 과체중군의 환아들에게서 만성 신질환 초기에도 유의 있게 높은 수치를 보여주었다. 따라서 과체중을 동반한 만성 신질환 환아들의 경우 비만에 대한 주의 깊은 관찰과 신질환의 악화를 막기 위한 조기 진단과 치료 및 예방에 힘쓰는 것이 필요할 것으로 사료된다.
Abstract
Purpose : Chronic kidney disease (CKD) and obesity are the worldwide public health problem. Obesity is an already well-established risk factor for CKD. The objective of this study is to evaluate the relationship between high BMI and increased risk for nephropathy by clinical data. Methods : Study group were 26 patients who had BMI≥ 25 kg/m2 and control group were 49 patients with BMI<25 kg/m2. Both groups received renal biopsy in Kyung Hee Medical Center between 2003. Jan.-2007. Dec. BMI was calculated from measured weight and height when they were admitted to the hospital. We collected laboratory data such as CBC and blood chemistry. Results : Our hypothesis was that overweight and obesity are associated with incidence and progression of CKD. From kidney biopsy, we found IgAN 17, MesPGN 5, HSPN 2, Intestitial nephritis 1, IgMN 1 (total 26) in the study group whereas IgAN 22, MesPGN 17, HSPN 3, MGN 3, benign hematuria 2, MPGN 1, Intestitial nephritis 1, (total 49) were found in the control group. There was no significant difference between the two groups. Overweight patients demonstrated significantly higher platelet, TG, ALT, and uric acid level compared to control group. Conclusion : We identified a significant relationship between overweight and development of CKD. These results suggest that overweight children have an increased risk for CKD than those who are not obese. So, we should pay attention to children with overweight who have CKD and earlier weight management is crucial to prevent aggravation of CKD.
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