中文摘要：

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100pg／ml，ORG的发病风险分别降低35％（OR=O．652，95％CI：0．487～0．872）和38％（OR=O．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。

英文摘要：

Objective 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. Forty- eight 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]. Muhinomial 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 （0R=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.