Okeahialam Basil N, Sirisena Anil I, Ike Emeka E, Chagok Nestor M
Department of Medicine, Jos University Teaching Hospital Jos, Nigeria.
Department of Radiology, Jos University Teaching Hospital Jos, Nigeria.
Am J Cardiovasc Dis. 2020 Dec 15;10(5):564-568. eCollection 2020.
Overweight/obesity has predicted cardiovascular disease (CVD) risk for long with its standard measure of body mass index (BMI), which later was found to mis-classify risk oftentimes. This is because it does not differentiate between fat and whole body mass. The finding that fat especially visceral fat was more culpable shifted attention to ectopic fat as a more precise measure of CVD risk. Peri-renal fat (PRF) is one such ectopic foci, which is hardly used despite the relative ease of assessment. We assessed PRF to correlate it with carotid intima media thickness (CIMT) to see if there was any significance in order to obviate need for heavy equipment in CVD risk assessment.
This is secondary analysis of data generated in the course of studying sub-clinical atherosclerosis in apparently normal individuals. Subjects underwent routine anthropometry to determine BMI. They then underwent abdominal ultrasound studies wherein PRF was measured as the size of the echogenic strip between the posterior part of the liver and the right kidney. The CIMT was measured using the same equipment but a different transducer, as the distance between the intima and medial layers of the right common carotid artery 1 cm proximal to the carotid bulb.
The 221 subjects (82 M, 139 F) had mean ages of 37.01±10.97 and 36.86±11.62 years respectively. PRF correlated significantly with CIMT, age and all anthropometric measures. A PRF level of 0.26 cm turned out to be a significant value that determined presence of sub-clinical atherosclerosis deriving from the receiver operating characteristic curve analysis.
PRF has shown to be correlated significantly with indices that predict atherosclerosis. Being an ectopic fat focus, its local and systemic effects on the kidney increase systemic vascular resistance and CVD. Since it can easily be measured on abdominal ultrasound, a test readily available and requiring lower level skills it should be used to advantage. Levels above 0.26 cm should prompt initiation of curative or preventive action to control CVD in the population.
超重/肥胖长期以来一直通过其标准测量指标体重指数（BMI）来预测心血管疾病（CVD）风险，但后来发现BMI常常会对风险进行错误分类。这是因为它没有区分脂肪和全身质量。脂肪尤其是内脏脂肪更具致病性这一发现，将注意力转移到异位脂肪，认为它是更精确的CVD风险测量指标。肾周脂肪（PRF）就是这样一个异位病灶，尽管评估相对容易，但却很少被使用。我们评估了PRF，并将其与颈动脉内膜中层厚度（CIMT）相关联，以查看是否存在任何意义，从而避免在CVD风险评估中需要重型设备。
这是对表面正常个体亚临床动脉粥样硬化研究过程中产生的数据进行的二次分析。受试者接受常规人体测量以确定BMI。然后他们接受腹部超声检查，其中PRF被测量为肝脏后部和右肾之间强回声带的大小。使用同一设备但不同探头测量CIMT，即测量颈动脉球近端1 cm处右颈总动脉内膜和中层之间的距离。
221名受试者（82名男性，139名女性）的平均年龄分别为37.01±10.97岁和36.86±11.62岁。PRF与CIMT、年龄和所有人体测量指标均显著相关。根据受试者工作特征曲线分析，PRF水平为0.26 cm被证明是确定亚临床动脉粥样硬化存在的一个显著值。
PRF已显示与预测动脉粥样硬化的指标显著相关。作为一个异位脂肪病灶，它对肾脏的局部和全身影响会增加全身血管阻力和CVD风险。由于它可以通过腹部超声轻松测量，这是一种容易获得且所需技能水平较低的检查，因此应加以利用。PRF水平高于0.26 cm时，应促使启动治疗或预防措施以控制人群中的CVD。
