摘要目的 探讨肥胖人群血清α-klotho蛋白水平与肥胖相关性肾小球病(ORG)发病之间的关系.方法 选取经肾穿刺病理检查确诊为ORG患者48例(ORG组),另选取性别、年龄、体重指数与之匹配的单纯性肥胖患者48例(单纯性肥胖组)和肥胖型慢性肾脏病患者48例(肥胖型CKD组).收集各组患者临床资料和实验室检查结果.采用酶联免疫吸附测定法(ELISA)检测血清α-klotho蛋白浓度.结果 3组间单因素比较结果显示,ORG组患者血清α-klotho水平[572.66 (439.92,690.58) pg/ml]明显低于单纯性肥胖组[635.85 (559.52,769.20)pg/ml]及肥胖型CKD组患者[690.30(516.15,828.20) pg/ml](均P＜0.01).多因素Logistic回归分析结果显示,与单纯性肥胖组和肥胖型CKD组相比,ORG组患者血清α-klotho水平每增加100 pg/ml,ORG的发病风险分别降低35％(OR=0.652,95％CI:0.487～ 0.872)和38％(OR=0.617,95％CI:0.453～ 0.832).结论 ORG患者血清α-klotho蛋白水平明显降低,与ORG发病独立相关,提示α-klotho可能是拮抗ORG发病的保护因子.

abstractsObjective To detect the level of serum α-klotho in different obese people and to investigate the correlation between serum α-klotho and obesity-related glomerulopathy (ORG).Methods A total of 48 cases of ORG diagnosed by renal biopsy were enrolled in the study.Fortyeight gender-,age-and BMI-matched obese participants,and 48 obese chronic kidney disease (CKD) patients without ORG were included as controls.The clinical manifestations,laboratory examinations of all three groups were collected,and the level of serum α-klotho protein was measured by ELISA.Results The patients with ORG were characterized by decreased serum α-klotho concentration compared with obese patients group and obese CKD patients group [572.66(439.92,690.58) pg/ml vs 635.85(559.52,769.20) pg/ml and 690.30(516.15,828.20) pg/ml,P＜ 0.01].Multinomial multiple logistic regression analysis revealed that serum α-klotho (per 100 pg/ml increased) was independently associated with the prevalence of ORG,and the risk of ORG decreased by 35％ in the obese participants (OR=0.652,95％ CI:0.487-0.872) and 38％ in CKD patients (OR=0.617,95％ CI:0.453-0.832) respectively.Conclusions The level of serum α-klotho is significantly decreased in ORG and associated with the prevalence of ORG independently.Serum α-klotho may be a protective factor for ORG.