Abstract: Objective    To investigate the clinical value of urine N-acetyl-β-D-glucosaminidase（uNAG）and serum cystatin-C（Cys-C）in the assessment of early renal damage in children with simple obesity . Methods    A total of 302 children with simple obesity were selected，who were diagnosed in the Department of Endocrinology，Genetics and Metabolism of Children's Hospital of Soochow University from October 2021 to January 2024，and 53 children of similar age in the same period were selected as the normal control group. The clinical data of the two groups were collected，including basic data，blood and urine test results，compare the differences in clinical data of different stages of obesity and normal control group. Analyze the correlation between serum Cys-C，urine NAG，and kidney function. Compare simple obesity group based on their urnie albumin creatine raio （UACR），dividing them into an albuminuria group and a normal albuminuria group. Examine the differences in general clinical data and laboratory parameters between these two subgroups. Multivariate Logistic regression analysis was used to identify the predictors of renal damage . Results    There were statistically significant differences in total cholesterol（TC），triglyceride（TG）and triglyceride-glucose index（TyG）between the obese albuminuria group and the obese no-albuminuria group（P<0.05），and there were significant differences in β2-microglobulin（mALB），uNAG and UACR（P<0.05）. In the obese albuminuria group，uNAG was moderately positively correlated with mALB and UACR，and moderately negatively correlated with β2M . uNAG was an independent influencing factor for early renal damage in children with simple obesity . The area under the ROC curve was the largest in the combined detection of uNAG and serum Cys-C，and the specificity and sensitivity were relatively high. Conclusion    The children with simple obesity may have early kidney damage . uNAG is an independent influencing factor for early renal damage in children with simple obesity . The combination of uNAG，uNAG and serum Cys-C has certain value in the evaluation of early renal damage in children with simple obesity . 

Key words: simple obesity in children, urine n-acetyl-β-D-glucosaminidase, obesity-related renal damage

摘要： 目的    探究尿N-乙酰β-D-氨基葡萄糖苷酶（urine N-acetyl-β-D-glucosaminidase，uNAG）和血清胱抑素C（cystatin-C，Cys-C）在单纯性肥胖儿童肾脏早期损害评估中的临床价值。方法    选取2021年10月至2024年1月苏州大学附属儿童医院内分泌遗传代谢科确诊302例单纯性肥胖儿童，与同期年龄相仿53例儿童为正常对照组，留取两组人群临床资料，包括基础资料，血液及尿液检查结果，比较肥胖不同病程和正常对照组的临床资料的差异性，分析血清Cys-C、尿NAG和肾功能的相关性，将单纯性肥胖儿童按照尿微量白蛋白/尿肌酐（urnie albumin creatine raio，UACR）分为白蛋白尿组和无白蛋白尿组，比较两组的一般临床资料、实验室检查参数的差异性。采用多变量Logistic回归分析找出肾脏损害的预测指标。结果    肥胖白蛋白尿组和肥胖无白蛋白尿组在总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、三酰甘油葡萄糖指数（triglyceride-glucose index，TyG）差异有统计学意义（P<0.05），在尿微量白蛋白（trace albumin in urine，mALB）、uNAG、UACR差异有统计学意义（P<0.01）。肥胖白蛋白尿组中的uNAG与mALB、UACR呈中度正相关，与β2微球蛋白（β2-Microglobulin，β2M）呈中度负相关。uNAG是单纯性肥胖儿童肾脏早期损伤的独立影响因素。uNAG和血清Cys-C联合检测时ROC曲线下面积最大，特异度、敏感度均较高。结论    单纯性肥胖儿童可能发生肾脏的早期损害。uNAG是单纯性肥胖儿童肾脏早期损伤的独立影响因素。uNAG和血清Cys-C联合在评估单纯性肥胖儿童肾脏早期损害均有一定价值。

关键词: 儿童单纯性肥胖, 尿N-乙酰β-D-氨基葡萄糖苷酶, 肥胖相关性肾损伤