Abstract
ObjectivesIncreased renal sinus fat (RSF) is associated with hypertension and chronic kidney disease, but underlying mechanisms are incompletely understood. We evaluated relations between RSF and gold-standard measures of renal hemodynamics in type 2 diabetes (T2D) patients.MethodsFifty-one T2D patients [age 63 ± 7 years; BMI 31 (28–34) kg/m2; GFR 83 ± 16 mL/min/1.73 m2] underwent MRI-scanning to quantify RSF volume, and subcutaneous and visceral adipose tissue compartments (SAT and VAT, respectively). GFR and effective renal plasma flow (ERPF) were determined by inulin and PAH clearances, respectively. Effective renal vascular resistance (ERVR) was calculated.ResultsRSF correlated negatively with GFR (r = − 0.38; p = 0.006) and ERPF (r = − 0.38; p = 0.006) and positively with mean arterial pressure (MAP) (r = 0.29; p = 0.039) and ERVR (r = 0.45, p = 0.001), which persisted after adjustment for VAT, MAP, sex, and BMI. After correction for age, ERVR remained significantly related to RSF.ConclusionsIn T2D patients, higher RSF volume was negatively associated to GFR. In addition, RSF volume was positively associated with increased renal vascular resistance, which may mediate hypertension and CKD development. Further research is needed to investigate how RSF may alter the (afferent) vascular resistance of the renal vasculature.
Highlights
Obesity is recognized as a heterogeneous condition, in which individuals with similar levels of body mass index (BMI) may have distinct metabolic, cardiovascular (CV), and renal risk [1]
Of the 54 patients who underwent both baseline testing days, 3 patients were excluded, because they presented with renal cysts (n = 1) or because their magnetic resonance imaging (MRI) scan was of insufficient quality to allow assessment of renal sinus fat (RSF) (n = 2)
The current study is the first to assess the relation between MRI-measured RSF and renal hemodynamics as measured by gold-standard inulin (GFR) and para-amino hippuric acid (PAH) (ERPF) clearance techniques
Summary
Obesity is recognized as a heterogeneous condition, in which individuals with similar levels of body mass index (BMI) may have distinct metabolic, cardiovascular (CV), and renal risk [1]. Variation in body fat distribution provides a potential explanation for some of these observations. RSF has been associated with systemic hypertension, which is a driver of CKD [11, 12]. This association is independent of other adipose tissue compartments [7, 11, 13].
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