The Impact of Obesity on the Severity of Clinicopathologic Parameters in Patients with IgA Nephropathy

Hong, Yu Ah; Min, Ji Won; Ha, Myung Ah; Koh, Eun Sil; Kim, Hyung Duk; Ban, Tae Hyun; Kim, Young Soo; Kim, Yong Kyun; Kim, Dongryul; Shin, Seok Joon; Choi, Won Jung; Chang, Yoon-Kyung; Kim, Suk Young; Park, Cheol Whee; Kim, Young Ok; Yang, Chul Woo; Yoon, Hye Eun

doi:10.3390/jcm9092824

Cited by 14 publications

(15 citation statements)

References 45 publications

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“…Additionally, Wu et al showed that high BMI was associated with a higher risk of interstitial fibrosis [ 28 ]. In our eight-center affiliation study, obesity was an independent risk factor for mesangial expansion [ 29 ]. In our study, clinical variables including BMI and HTG independently increased the risk of glomerulosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

Choi

Hong

Min

et al. 2021

JCM

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IgA nephropathy (IgAN) is a globally well-known primary glomerular nephropathy. Hypertriglyceridemia (HTG) is one factor contributing to atherosclerosis and is a common complication of renal failure. HTG is a significant risk factor for decreased renal function in patients with IgAN. We evaluated the association of HTG with the histopathological features of IgAN patients. A total of 480 patients diagnosed with IgAN via kidney biopsy from eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea were included in the final cohort. Pathological features were evaluated by eight expert pathologists with hospital consensus. HTG was defined as a serum triglyceride (TG) level of ≥150 mg/dL. In the study population analysis, the HTG group was older, with more males; higher body mass index (BMI), low-density lipoprotein cholesterol (LDL-C) and spot urine protein ratio; and lower estimated glomerular filtration rate (eGFR). In the lipid profile analysis, eGFR was negatively correlated with TGs/ high-density lipoprotein cholesterol (HDL) and triglyceride-glucose index (TyG). Proteinuria positively correlated with TGs/HDL, non-HDL/HDL, LDL/HDL, TyG, TGs and LDL. The percentages of global sclerosis (GS), segmental sclerosis (SS) and capsular adhesion (CA), and the scores for mesangial matrix expansion (MME) and mesangial cell proliferation (MCP), were more elevated in the HTG group compared to the normal TG group. Multivariable linear regression analysis showed that the percentages of global sclerosis, segmental sclerosis and capsular adhesion, as well as the scores for mesangial matrix expansion and mesangial cell proliferation, were positively associated with TG level. In binary logistic regression, the HTG group showed a higher risk for global sclerosis and segmental sclerosis. In conclusion, HTG is a significant risk factor for glomerulosclerosis in IgAN.

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Section: Discussionmentioning

confidence: 99%

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

Choi

Hong

Min

et al. 2021

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“…However, the MEST-C scoring system roughly reflects the extent of tissue damage in a way that scores with 0 and 1 (M, E, S) or 0, 1, and 2 (T) for each item. For this reason, we analyze key histological damage mentioned above with a more specialized hospital consensus scoring system [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

The Serum Uric Acid Level Is Related to the More Severe Renal Histopathology of Female IgA Nephropathy Patients

Choi

Hong

Min

et al. 2021

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Hyperuricemia is a significant risk factor for cardiovascular morbidity and chronic kidney disease progression. IgA nephropathy (IgAN) is a well-known primary glomerular nephropathy. Hyperuricemia is associated with a poor prognosis in IgAN patients. We evaluated the association of hyperuricemia with the histopathological severity of IgAN in male and female patients; 658 patients diagnosed with IgAN via kidney biopsy were initially included. Baseline patient data were collected by eight university hospitals affiliated with the College of Medicine of the Catholic University of Korea. Pathological features were independently evaluated by eight expert pathologists working in the hospitals, and the consensus was reached. Of the initial 658 patients, 517 were finally included (253 males and 264 females). Hyperuricemia was defined as a serum uric acid (UA) level >7.0 mg/dL for males and >5.6 mg/dL for females; 108 (42.7%) males and 95 (35.9%) females exhibited hyperuricemia. Compared to the patients with normal UA levels, the global glomerulosclerosis, segmental sclerosis, mesangial matrix expansion (MME), endocapillary proliferation (ECP), interstitial fibrosis (IF), and tubular atrophy (TA) scores were higher in hyperuricemic males and females. In multivariable linear regression, the serum UA level correlated significantly with the MME, ECP, IF, and TA scores of female IgAN patients only.

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“…3 Recent epidemiologic studies noted that high BMI was a risk factor for chronic comorbidities, including hypertension, type 2 diabetes mellitus, dyslipidemia, cardiovascular disease, chronic kidney disease (CKD), and cancer. 2,4 CKD was shown to be the second common cause of obesity-related mortality only next to cardiovascular disease. Obesity has drawn more attention as a prognostic factor for CKD.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical and experimental researches have also demonstrated obesity-related glomerulopathy, which is characterized by glomerulomegaly, thickening of glomerular basement membrane (GBM), mesangial matrix expansion, and focal segmental glomerulosclerosis. 4,6 CKD is defined as the structural or functional alterations of the kidney that persists for three or more months. Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide, which results in CKD.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the incidence of idiopathic membranous nephropathy (IMN) has surged rapidly and is only second to IgAN. 4,6 Membranous nephropathy (MN) is characterized by the deposit of immune complexes in the epithelial cells of the GBM. IMN refers to the unexplained MN, which accounts for approximately 80% of MN patients, and is one of the most common pathological types of nephrotic syndrome in adults.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Body Mass Index with Clinicopathologic Parameters in Patients with Idiopathic Membranous Nephropathy

Chen¹,

Chen²,

Li³

et al. 2022

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To investigate the association between body mass index (BMI) and clinicopathologic parameters in patients with idiopathic membranous nephropathy (IMN). Methods: This study was retrospective and included patients with biopsy-proven IMN from 2018 to 2021 in Hebei General Hospital. Patients were categorized into two groups based on BMI. Clinical and histopathologic data were analyzed at the time of renal biopsy. Pathological data included immunofluorescence staining, glomerulosclerosis (GS, 0-2), mesangial cell proliferation (MCP, 0-1), tubular atrophy (TA, 0-1), interstitial fibrosis (IF, 0-1), vascular wall thickness (VWT, 0-1) and a combination score (GMTIV) graded from 0 to 5. Results: Our study revealed that the obese group had a higher prevalence of hypertension and diabetes than the overweight/normal weight group (P=0.001, P=0.002). Systolic blood pressure (P=0.005), diastolic blood pressure (P<0.001), haemoglobin (P=0.006), triglycerides (P<0.001), serum uric acid (P=0.05), 24 h urine proteinuria concentration (UP) (P=0.012), MCP (P=0.042), IF (P=0.033), and GMITV (P=0.033) score were higher in obese group compared to the other group, while the high-density lipoprotein-cholesterol (P=0.034) and immunoglobulin A deposition score (P=0.005) were lower. Factors significantly associated with UP were the ratio of lymphocyte count to white blood cell count, serum pre-albumin, immunoglobulin G, microscopic hematuria, anti-phospholipase A2 receptor (anti-PLA2R), C3 deposit on multivariable analysis (adjusted R 2 =0.343). Binary logistic regression analysis illustrated that MCP was correlated to BMI (OR=2.528, P=0.036). Ordinal logistic regression analysis demonstrated that GMTIV was associated with BMI (OR=1.114, P=0.010) and C3 deposit (OR=1.655, P=0.001). Conclusion: High BMI was associated with MCP and GMTIV score in IMN patients. Obesity may play an essential role in mesangial lesions of IMN. This study emphasized the relation between BMI and histological parameters under the universal usage of anti-PLA2R antibodies for diagnosis and prognosis in IMN.

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The Impact of Obesity on the Severity of Clinicopathologic Parameters in Patients with IgA Nephropathy

Cited by 14 publications

References 45 publications

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

Hypertriglyceridemia Is Associated with More Severe Histological Glomerulosclerosis in IgA Nephropathy

The Serum Uric Acid Level Is Related to the More Severe Renal Histopathology of Female IgA Nephropathy Patients

Correlation of Body Mass Index with Clinicopathologic Parameters in Patients with Idiopathic Membranous Nephropathy

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