Effect of childhood obesity and obesity-related cardiovascular risk factors on glomerular and tubular protein excretion

Csernus, Katalin; Lányi, E; Erhardt, Éva; Molnár, Denés

doi:10.1007/s00431-004-1546-2

Cited by 78 publications

(70 citation statements)

References 36 publications

(48 reference statements)

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“…In this context, adolescents with optimal and average KIDMED score compared with those with low score had higher values of body mass index and waist circumference, whereas exhibit lower ACR levels. Our findings are in contrary to studies based on data from obesity clinics in which ACR was found to be higher in obese children compared with normal weight children of the same age, underscoring the relation between obesity and albuminuria in pediatric population (Csernus et al, 2005;Burgert et al, 2006;Invitti et al, 2006). Nevertheless, in consistency with our results an analysis of the general adolescent population of the NHANES data showed that the prevalence of microalbuminuria was higher in non-obese teenagers and ACR was related with glucose metabolism dysregulation (Nguyen et al, 2008).…”

Section: Discussioncontrasting

confidence: 54%

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

et al. 2010

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Background/Objectives: Mediterranean diet has favorable effects on the cardiovascular system, whereas albuminuria is associated with atherosclerosis progression. The aim of the study was to assess the relationships of adherence rates to the Mediterranean diet with albumin to creatinine ratio (ACR), in a cohort of Greek adolescents who participated in the Leontio Lyceum ALbuminuria (3L) study. Subjects/Methods: In a total of 365 adolescents 12-17 years of age included in 3L study, ACR values were determined in a morning-spot urine. Results: The Mediterranean diet Quality Index for children and adolescents (KIDMED) was estimated and accordingly subjects were divided into those with high (X8), average (4-7) and low (p3) score. Adolescents with low (n ¼ 153, 42%) compared with those with average (n ¼ 187, 51.2%) and high (n ¼ 25, 6.8%) KIDMED score were characterized by greater ACR values (22.4 vs 13.4 vs 12.1 mg/g, Po0.05) even after adjustment for confounders. In the total population, KIDMED score was related to body mass index (r ¼ 0.122, P ¼ 0.02), waist circumference (r ¼ 0.118, P ¼ 0.02), systolic blood pressure (BP) (r ¼ 0.119, P ¼ 0.023), whereas it was negatively associated with ACR (r ¼ À0.111, P ¼ 0.041). Regarding ACR, it was associated with age (r ¼ À0.11, P ¼ 0.044), male sex (r ¼ 0.16, P ¼ 0.003), body mass index (r ¼ À0.131, P ¼ 0.016) and systolic BP (r ¼ À0.144, P ¼ 0.008). Conclusions: Adolescents who adhere to the Mediterranean diet exhibit lower levels of albuminuria, independently of demographic and hemodynamic confounders. The inverse relation of KIDMED index with ACR suggests a close link of accelerated vascular damage reflected by albuminuria with low adherence to this favorable diet of the Mediterranean basin.

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Section: Discussioncontrasting

confidence: 54%

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

et al. 2010

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“…Csernus et al (28) reported a positive association between proteinuria and adult obesity, consistent with the identification of obesity as an independent risk factor for proteinuria. However, in other studies, either proteinuria was not related to obesity (29) or obese children had higher albuminuria than the control group (28).…”

Section: Discussionsupporting

confidence: 53%

Prevalence of Proteinuria in School-Aged Turkish Children, and Its Association with Obesity and Hypertension

Gül¹,

Özer²,

Yılmaz³

et al. 2017

jpr

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ABS TRACTÖz Aim: In kidney diseases, renal damage may be mild and initially asymptomatic. Proteinuria, a marker of kidney injury, directly contributes to chronic tubulointerstitial damage. We investigated the prevalence of proteinuria (POP) in school-aged children in Turkey. Materials and Methods: The cluster sampling method was used to calculate the required size of the study group for this cross-sectional study. Urine samples were randomly obtained to determine urinary protein/creatinine ratio (Upr/Ucr) from 1374 children aged 6 to 18 years. POP was also specifically assessed in hypertensive and obese children. Results: The mean age of the subjects was 11.68±3.43 years. The children were from rural (23.9%) and urban (76.1%) regions of Tokat, Turkey. Upr/Ucr ≥0.20 was detected in 92 children, corresponding to a POP rate of 6.7%, without any statistically significant difference between girls and boys. Among 141 obese children, 16 (11.3%) and 76 of 1233 non-obese children (6.2%) had proteinuria (p<0.05). Children with hypertension had a POP of 7.5% compared to the 6.7% of those without hypertension (p>0.05). Conclusion: Among school-aged Turkish children POP was 6.7%. POP was higher in obese than in non-obese children. But there was no association between POP and hypertension. While screening programs allow the early detection of renal disease, further cohort studies are required to be able to suggest urinary screening programs. Keywords: Proteinuria, children, obesity, protein creatinine ratio, hypertension Amaç: Böbrek hastalıklarında renal hasar başlangıçta asemptomatik ve hafif olabilir. Böbrek hasarının bir belirteci olan proteinüri, kronik tübülointerstisyel hasara doğrudan katkıda bulunur. Okul çağındaki çocuklarda proteinüri prevalansını (PP) araştırdık. Gereç ve Yöntemler: Bu kesitsel çalışma için çalışma grubunun gerekli boyutunu hesaplamak için küme örnekleme yöntemi kullanıldı. Altı-on sekiz yaş arasındaki 1374 çocuğun idrar protein/kreatinin oranını (Upr/Ucr) belirlemek için idrar numuneleri rastgele elde edildi. PP hipertansif ve obez çocuklarda ayrıca hesaplandı. Bulgular: Olguların yaş ortalaması 11,68±3,43 yıl idi. Olguların %23,9'u kırsal alanlardan ve %76,1'i kentsel bölgeden alındı. Kız ile erkek çocuklar arasında istatistiksel olarak anlamlı farklılık olmaksızın, 92 çocukta Upr/Ucr ≥0,20 saptandı, PP %6,7'ye karşılık geldi. Yüz kırk bir obez çocuktan 16'sında (%11,3) proteinüri vardı; obez olmayan 1233 çocuğun 76'sında (%6,2) proteinüri vardı (p<0,05). Hipertansiyonlu çocuklarda proteinüri %7,5 iken hipertansif olmayanlardaki prevalans oranı %6,7 idi (p>0,05). Sonuç: Okul çağındaki Türk çocuklarında PP %6,7 idi. PP, obezlerde obez olmayan çocuklardan daha yüksekti. Ancak, PP ve hipertansiyon arasında herhangi bir ilişki mevcut değildi. Tarama programları, böbrek hastalığını erken tespitte yardımcı olsa da üriner tarama programlarının önerilmesi için daha fazla kohort araştırmaları gereklidir.

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“…This condition is quite common in obese children and adolescents. Csernus et al showed elevated levels of albuminuria and β2-microglobulinuria in obese children versus normal weight children, suggesting early renal glomerular and tubular injury as a consequence of obesity in children [12]. Ferris et al demonstrated that microalbuminuria was strongly related to the severity of obesity in adults.…”

Section: Microalbuminuriamentioning

confidence: 99%

Early markers of obesity-related renal injury in childhood

Ding

Mak

2014

Pediatr Nephrol

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Childhood obesity has become a global epidemic. Recent epidemiological data suggest that obesity is associated with increased risk of renal injury in children. The onset of obesity-associated renal disease is insidious and asymptomatic, so early markers will be extremely useful in its prevention and treatment. Biomarker discovery can be focused on unbiased or biased (candidate) approaches. Unbiased approaches using innovative technologies, such as proteomics and metabolomics, have uncovered candidates that are emerging as plausible biomarkers for such renal disorders as obstructive uropathy and diabetic nephropathy. Biased approaches are based on hypotheses related to glomerular or tubular injury pathophysiology in obesity. Goknar et al. (Pediatric Nephrology 2014; doi: 10.1007/s00467-014-2829 recently evaluated early urine renal injury markers, namely, microalbuminuria, N-acetyl-beta-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin, and kidney injury molecule (KIM)-1, in obese children. They reported that obese children had higher urinary NAG and KIM-1 levels than healthy controls. Longitudinal observation studies are needed to evaluate whether these tubular damage markers are useful as early markers of renal injury in obese children.

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Effect of childhood obesity and obesity-related cardiovascular risk factors on glomerular and tubular protein excretion

Cited by 78 publications

References 36 publications

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

Adherence to the Mediterranean diet and albuminuria levels in Greek adolescents: data from the Leontio Lyceum ALbuminuria (3L study)

Prevalence of Proteinuria in School-Aged Turkish Children, and Its Association with Obesity and Hypertension

Early markers of obesity-related renal injury in childhood

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