Renal sinus fat volume in type 2 diabetes mellitus is associated with glycated hemoglobin and metabolic risk factors

Lin, Ling; Dekkers, Ilona A.; Huang, Lu; Tao, Qian; Paiman, Elisabeth H.M.; Bizino, Maurice B.; Jazet, Ingrid M.; Lamb, Hildo J.

doi:10.1016/j.jdiacomp.2021.107973

Cited by 21 publications

(23 citation statements)

References 39 publications

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“…With an increase in pro-inflammatory signalling, the kidney sinus fat may have a negative impact on the kidney function and in the development of chronic kidney disease [ 50 ]. Thus, a reduction in albuminuria due to weight loss and KSF loss might not only improve chronic kidney disease, but may also reduce the risk for cardiovascular events [ 45 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Kidney Fat upon Dietary-Induced Weight Loss

et al. 2022

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As the metabolic role of kidney fat remains unclear, we investigated the effects of dietary weight loss on kidney fat content (KFC) and its connection to kidney function and metabolism. Overweight or obese participants (n = 137) of a dietary intervention trial were classified into quartiles of weight loss in a post hoc manner. Kidney sinus (KSF) and cortex fat (KCF) were measured by magnetic resonance imaging at baseline, week 12 and week 50. Weight loss effects on KFC were evaluated by linear mixed models. Repeated measures correlations between KFC, other body fat measures and metabolic biomarkers were obtained. KSF, but not KCF, decreased significantly across weight loss quartiles at week 12 (quartile 4: −21.3%; p = 0.02) and 50 (−22.0%, p = 0.001), which remained significant after adjusting for VAT. There were smaller improvements regarding creatinine (−2.5%, p = 0.02) at week 12, but not week 50. KSF, but not KCF, correlated with visceral (rrm = 0.38) and subcutaneous fat volumes (rrm = 0.31) and liver fat content (rrm = 0.32), as well as diastolic blood pressure and biomarkers of lipid, glucose and liver metabolism. Dietary weight loss is associated with decreases in KSF, but not KCF, which suggests that KSF may be the metabolically relevant ectopic fat depot of the kidney. KSF may be targeted for obesity-related disease prevention.

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Section: Discussionmentioning

confidence: 99%

Changes in Kidney Fat upon Dietary-Induced Weight Loss

et al. 2022

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“…Indeed, renal sinus fat volume is significantly increased in prediabetic subjects and associated with visceral fat mass and cardiovascular risk factors. These data suggest that this tissue may undergo early changes during the development of metabolic disease and may link metabolic disease and associated CKD, even serving as an early biomarker for this disease [ 70 , 71 ].…”

Section: Role Of Adipose Tissue In Obesity-associated Chronic Kidney ...mentioning

confidence: 99%

Novel Insights in the Physiopathology and Management of Obesity-Related Kidney Disease

et al. 2022

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Obesity is recognized as an independent risk factor for the development of kidney disease, which has led to the designation of obesity-related glomerulopathy (ORG). Common renal features observed in this condition include glomerular hypertrophy, glomerulosclerosis, haemodynamic changes and glomerular filtration barrier defects. Additionally, and although less studied, obesity-related kidney disease also involves alterations in renal tubules, including tubule hypertrophy, lipid deposition and tubulointerstitial fibrosis. Although not completely understood, the harmful effects of obesity on the kidney may be mediated by different mechanisms, with alterations in adipose tissue probably playing an important role. An increase in visceral adipose tissue has classically been associated with the development of kidney damage, however, recent studies point to adipose tissue surrounding the kidney, and specifically to the fat within the renal sinus, as potentially involved in the development of ORG. In addition, new strategies for the treatment of patients with obesity-related kidney disease are focusing on the management of obesity. In this regard, some non-invasive options, such as glucagon-like peptide-1 (GLP-1) receptor agonists or sodium–glucose cotransporter-2 (SGLT2) inhibitors, are being considered for application in the clinic, not only for patients with diabetic kidney disease but as a novel pharmacological strategy for patients with ORG. In addition, bariatric surgery stands as one of the most effective options, not only for weight loss but also for the improvement of kidney outcomes in obese patients with chronic kidney disease.

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“…High-serum total cholesterol, high very low-density lipoprotein cholesterol (VLDL-C), high LDL-C, high fasting plasma glucose or HbA1c, high gamma-glutamyl transferase and low HDL-C levels are the major variables that associate with greater renal sinus fat accumulation along with certain medical conditions including hypertension, diabetes mellitus and metabolic syndrome (Figure 2). 8,59 There are two hypotheses regarding how fat accumulation in the kidneys may cause kidney disease. The first, based on work by Moorhead and colleagues, assumes that renal parenchymal fat accumulation leads to inflammation and oxidative stress with pro-inflammatory cytokines that damage the renal vasculature, mesangial cells, proximal tubule epithelium and podocytes, thus creating a local environment of electrical insulation, possibly impairing cross-talk between the kidney and other organs.…”

Section: Pathogenesis Of Kidney Injury In Fatty Kidneymentioning

confidence: 99%

“…High‐serum total cholesterol, high very low‐density lipoprotein cholesterol (VLDL‐C), high LDL‐C, high fasting plasma glucose or HbA1c, high gamma‐glutamyl transferase and low HDL‐C levels are the major variables that associate with greater renal sinus fat accumulation along with certain medical conditions including hypertension, diabetes mellitus and metabolic syndrome (Figure 2). 8,59 …”

Section: Pathogenesis Of Kidney Injury In Fatty Kidneymentioning

confidence: 99%

Fatty kidney: A possible future for chronic kidney disease research

Kanbay

Çöpür

Demiray

et al. 2022

Eur J Clin Investigation

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Background: Metabolic syndrome is a growing twenty-first century pandemic associated with multiple clinical comorbidities ranging from cardiovascular diseases, non-alcoholic fatty liver disease and polycystic ovary syndrome to kidney dysfunction. A novel area of research investigates the concept of fatty kidney in the pathogenesis of chronic kidney disease, especially in patients with diabetes mellitus or metabolic syndrome. Aim: To review the most updated literature on fatty kidney and provide future research, diagnostic and therapeutic perspectives on a disease increasingly affecting the contemporary world. Materials and Method: We performed an extensive literature search through three databases including Embase (Elsevier) and the Cochrane Central Register of Controlled Trials (Wiley) and PubMed/Medline Web of Science in November 2021 by using the following terms and their combinations: 'fatty kidney', 'ectopic fat', 'chronic kidney disease', 'cardiovascular event', 'cardio-metabolic risk', 'albuminuria' and 'metabolic syndrome'. Each study has been individually assessed by the authors.Results: Oxidative stress and inflammation, Klotho deficiency, endoplasmic reticulum stress, mitochondrial dysfunction and disruption of cellular energy balance appear to be the main pathophysiological mechanisms leading to tissue damage following fat accumulation. Despite the lack of large-scale comprehensive studies in this novel field of research, current clinical trials demonstrate fatty kidney as an independent risk factor for the development of chronic kidney disease and cardiovascular events. Conclusion:The requirement for future studies investigating the pathophysiology, clinical outcomes and therapeutics of fatty kidney is clear.

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Renal sinus fat volume in type 2 diabetes mellitus is associated with glycated hemoglobin and metabolic risk factors

Cited by 21 publications

References 39 publications

Changes in Kidney Fat upon Dietary-Induced Weight Loss

Changes in Kidney Fat upon Dietary-Induced Weight Loss

Novel Insights in the Physiopathology and Management of Obesity-Related Kidney Disease

Fatty kidney: A possible future for chronic kidney disease research

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