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Obesity Surgery

, Volume 29, Issue 11, pp 3581–3588 | Cite as

Albuminuria in Patients with Morbid Obesity and the Effect of Weight Loss Following Bariatric Surgery

  • Johanna Maria Brix
  • Carsten Thilo Herz
  • Hans Peter Kopp
  • Astrid Feder
  • Eva-Christina Krzizek
  • Christoph Sperker
  • Gerit-Holger Schernthaner
  • Guntram Schernthaner
  • Bernhard LudvikEmail author
Original Contributions
  • 76 Downloads

Abstract

Background and Objectives

Patients with morbid obesity are at an increased risk for cardiovascular and renal complications, which are not only linked to traditional cardiovascular risk factors. Thus, we evaluated (a) the prevalence of albuminuria in non-diabetic and diabetic morbidly obese patients and (b) the effect of weight loss following bariatric surgery.

Material and Methods

We included 1307 patients (77% women, mean age 40 ± 12 years, BMI 45.6 ± 6.6 kg/m2) in a cross-sectional study. A subgroup (n = 318) was followed up for 2 years after bariatric surgery. Weight, cardiovascular risk markers and a 75-g glucose tolerance test were determined. Albuminuria was assessed by collecting 24-h urine on three consecutive days.

Results

In the cross-sectional study, the prevalence of microalbuminuria was 16.0% (n = 209), of macroalbuminuria 3.1% (n = 41). The chi-square for the association of albuminuria and diabetes was 31.937 (p < 0.001). Of all patients with albuminuria, 42.0% exhibited normal glucose tolerance. In a multivariate regression analysis, systolic blood pressure (beta = 0.236; p < 0.001), log fasting insulin (beta = 0.309; p < 0.001) and log 2-h postprandial insulin (beta = − 0.173; p = 0.033) were predictive risk factors for albuminuria. Longitudinally, albumin excretion decreased significantly from 11.1 (6.4, 18.4 mg/24 h) to 7.8 mg/24 h (4.9, 13.0 mg/24 h; p < 0.001). In the group with albuminuria preoperatively, albumin excretion decreased from 65.7 (38.2, 147.1 mg/24 h) to 13.5 mg/24 h (8.4, 36.8 mg/24 h; p < 0.001). After adjusting for age, sex and baseline albuminuria, patients with lower creatinine clearance showed a smaller decrease of albuminuria (beta = 0.117; p = 0.021).

Conclusion

A substantial portion of patients with morbid obesity exhibits microalbuminuria, nearly half of those present with normal glucose tolerance. After weight loss, we found a significant decrease of albuminuria, potentially indicating or even contributing to the known reduction of cardiovascular mortality after bariatric surgery.

Keywords

Albuminuria Weight loss Morbid obesity Bariatric surgery 

Notes

Acknowledgements

We thank E Lobersiner and B Markl for the important contribution for this work.

Compliance with Ethical Standards

The study was approved by the institutional ethics committee and complies with the Declaration of Helsinki including current revisions and the Good Clinical Practice guidelines. The procedures performed were in accordance with institutional guidelines and all subjects gave written informed consent before the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Johanna Maria Brix
    • 1
    • 2
  • Carsten Thilo Herz
    • 3
  • Hans Peter Kopp
    • 1
    • 2
  • Astrid Feder
    • 1
    • 2
  • Eva-Christina Krzizek
    • 1
    • 2
  • Christoph Sperker
    • 4
  • Gerit-Holger Schernthaner
    • 5
  • Guntram Schernthaner
    • 1
  • Bernhard Ludvik
    • 1
    • 2
    Email author
  1. 1.Department of Medicine IRudolfstiftung HospitalViennaAustria
  2. 2.Karl Landsteiner Institute for Obesity and Metabolic DisordersViennaAustria
  3. 3.Department of Medicine III, Division of EndocrinologyMedical University of ViennaViennaAustria
  4. 4.Department of SurgeryRudolfstiftung HospitalViennaAustria
  5. 5.Department of Medicine II, Division of AngiologyMedical University of ViennaViennaAustria

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