title: Clinicopathological influence of obesity in IgA nephropathy: comparative study of 74 patients.
abstract: The pathological role of obesity has rarely been studied in primary glomerular diseases. The purpose of this study is to examine the clinicopathological influence of obesity in IgA nephropathy (IgAN). 74 patients with IgA nephropathy in our institution from October 2000 to January 2004 were retrospectively divided into two groups according to body mass index (BMI): the non-obese group (group N) with BMI < 25 kg/m(2), and the obese group (group O) with BMI > or = 25 kg/m(2). There were 50 patients in group N and 24 patients in group O. Clinical analysis showed no significant difference between these two groups in blood pressure, serum cholesterol, creatinine clearances or grade of hematuria. However, urinary protein excretion and serum creatinine were significantly greater in group O than in group N. Although semiquantitative analysis of light-microscopical findings showed no significant differences in the severity of mesangial proliferation, matrix expansion, glomerulosclerosis or crescent formation, image analysis showed that total glomerular area and tuft area were significantly larger in group O. In addition, ultrastructural study revealed significantly higher glomerular basement membrane thickness in group O. 62 patients (46 patients, group N; 16 patients, group O) were followed in our institution for one year. Urinary protein was significantly decreased only in patients who received steroid in both groups. Although administration of ACE inhibitor or ARB tended to decrease urinary protein in group O, the change was not statistically significant. Our findings indicate that obesity may accelerate the increase of proteinuria in IgAN through ultrastructural modification of the glomerular basement membrane.
authors.affiliation: Department of Nephrology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Tanaka
authors.forename: Tomomi
authors.initials: T
authors.lastname: Tsujii
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Komiya
authors.forename: Yukako
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sugishita
authors.forename: Satomi
authors.initials: S
authors.lastname: Yonemoto
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukui
authors.forename: Akimasa
authors.initials: A
authors.lastname: Takasu
authors.forename: Eri
authors.initials: E
authors.lastname: Muso
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D050533:Glomerular Basement Membrane / Q000473:pathology*; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000473:pathology*; D011507:Proteinuria / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids