Objectives

Increased 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.

Methods

Fifty-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.

Results

RSF 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.

Conclusions

In 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.

中文翻译：

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肾窦脂肪和肾脏血液动力学：横断面分析

目标

肾窦脂肪（RSF）增加与高血压和慢性肾脏疾病有关，但其潜在机制尚不完全清楚。我们评估了2型糖尿病（T2D）患者的RSF与肾血液动力学的金标准测量之间的关系。

方法

52名T2D患者[年龄63±7岁；BMI 31（28-34）kg / m ²；对GFR 83±16 mL / min / 1.73 m ² ]进行MRI扫描以定量RSF体积以及皮下和内脏脂肪组织区室（分别为SAT和VAT）。GFR和有效肾血浆流量（ERPF）分别通过菊粉和PAH清除率确定。计算有效肾血管阻力（ERVR）。

结果

RSF与GFR（r  = − 0.38; p  = 0.006）和ERPF（r  = − 0.38; p  = 0.006）呈负相关，与平均动脉压（MAP）（r  = 0.29; p  = 0.039）和ERVR正相关（r  = 0.45，p  = 0.001），在调整了增值税，MAP，性别和BMI之后仍然存在。校正年龄后，ERVR仍与RSF显着相关。

结论

在T2D患者中，较高的RSF量与GFR负相关。此外，RSF量与肾血管阻力增加呈正相关，这可能介导高血压和CKD的发展。需要进行进一步的研究来研究RSF如何改变肾血管的（耐药性）血管阻力。