Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
Sci Rep. 2023 Jun 6;13(1):9151. doi: 10.1038/s41598-023-36390-z.
Obesity is characterized by the accumulation of adipose tissue in different body compartments. Whether adipose tissue directly affects kidney function is still unknown. We aimed to investigate the role of the adipose tissue and circulating creatinine, cystatin C and kidney function in subjects free of cardio-renal diseases. In the KORA-MRI population-based study, 377 subjects (mean age 56.2 ± 9.2 years; 41.6% female) underwent whole-body 3T-MRI examination. Adipose tissue defined as visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were quantified from T1-DIXON sequence using a semi-automatic algorithm. Serum creatinine and cystatin C were measured using standard laboratory and estimated glomerular filtration rate (e-GFR) was performed based on creatinine (e-GFR), cystatin C (e-GFR) and creatinine-cystatin C (e-GFR). Linear regression analysis, adjusted for risk factors, was used to investigate the relationship between adipose tissue and circulating creatinine, cystatin C, and kidney function. In multivariate analyses VAT was inversely associated with eGFR (ß = - 4.88, p = < 0.001), and positively associated with serum cystatin C (ß = 0.05, p = < 0.001), respectively. No association was found between other adipose parameters such as total adipose tissue (TAT) and subcutaneous adipose tissue (SAT) and serum creatinine, urine microalbumin and eGFR. Stratified analyses according to BMI revealed confirmatory results for category of BMI > 30. VAT is positively associated with serum cystatin C and inversely with eGFR based on cystatin C, suggesting a direct involvement of visceral adipose tissue in increased metabolism of cystatin C and consequently decreased kidney function.
肥胖的特征是身体不同部位脂肪组织的积累。脂肪组织是否直接影响肾脏功能尚不清楚。我们旨在研究无心脏-肾脏疾病的受试者中脂肪组织、循环肌酐、胱抑素 C 和肾功能的作用。在基于 KORA-MRI 的人群研究中，377 名受试者（平均年龄 56.2±9.2 岁；41.6%为女性）接受了全身 3T-MRI 检查。使用半自动算法从 T1-DIXON 序列中定量了脂肪组织，定义为内脏脂肪组织 (VAT) 和皮下脂肪组织 (SAT)。使用标准实验室测量血清肌酐和胱抑素 C，并基于肌酐 (e-GFR)、胱抑素 C (e-GFR) 和肌酐-胱抑素 C (e-GFR) 计算估计肾小球滤过率 (e-GFR)。采用线性回归分析，调整了危险因素，以研究脂肪组织与循环肌酐、胱抑素 C 和肾功能之间的关系。在多元分析中，VAT 与 eGFR 呈负相关（β= -4.88，p<0.001），与血清胱抑素 C 呈正相关（β=0.05，p<0.001）。其他脂肪参数，如总脂肪组织 (TAT) 和皮下脂肪组织 (SAT) 与血清肌酐、尿微量白蛋白和 eGFR 之间无相关性。根据 BMI 进行分层分析显示，BMI>30 的类别证实了结果。VAT 与血清胱抑素 C 呈正相关，与基于胱抑素 C 的 eGFR 呈负相关，提示内脏脂肪组织直接参与胱抑素 C 的代谢增加，从而导致肾功能下降。
