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2016 ; 1
(4
): 250-255
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Glomerulopathy Associated With Moderate Obesity
#MMPMID29142929
Okabayashi Y
; Tsuboi N
; Sasaki T
; Haruhara K
; Kanzaki G
; Koike K
; Miyazaki Y
; Kawamura T
; Ogura M
; Yokoo T
Kidney Int Rep
2016[Nov]; 1
(4
): 250-255
PMID29142929
show ga
INTRODUCTION: Obesity-related glomerulopathy is an established secondary
glomerular disease that may occur in obese individuals with a body mass index
(BMI) of ?30 kg/m(2). However, patients with moderate obesity (BMI ? 30 kg/m(2))
may also develop this disease. METHODS: A total of 20 patients with grade 1
obesity (25 ? BMI < 30 kg/m(2)) with persistent proteinuria, without evidence of
other renal diseases, were analyzed retrospectively. These patients were compared
with 20 patients with grade 2 or higher obesity (BMI ? 30 kg/m(2)) with
persistent proteinuria. Biopsies of 31 kidney transplant donors as healthy
controls were used to compare histologic parameters. RESULTS: Similar to the
grade 2 or higher obesity group, the grade 1 obesity group had a male
predominance (85%) and showed a high incidence of hypertension (80%). Urinary
protein excretion and renal outcome parameters were comparable between the
groups. Patients with grade 1 obesity showed typical histologic features of
obesity-related glomerulopathy: low glomerular density with glomerulomegaly. The
glomerular density and mean glomerular volume in the grade 1 group, the grade 2
or higher group, and the kidney transplant donors with grade 1 obesity were 1.6 ±
0.8 versus 1.4 ± 0.6 versus 3.0 ± 1.1 (per mm(2)) and 6.1 ± 2.1 versus 6.4 ± 1.6
versus 2.9 ± 0.8 (×10(6) ?m(3)), respectively. DISCUSSION: A glomerulopathy
similar to obesity-related glomerulopathy can occur in moderately obese
individuals. Renal factor(s), such as low glomerular density, may thus underlie
susceptibility to this disease entity as well as BMI.