Westenberg Lisa B, van Londen Marco, Zorgdrager Marcel, McAdams-DeMarco Mara A, Segev Dorry L, Bakker Stephan J L, Viddeleer Alain R, Pol Robert A
Department of Surgery, Division of Transplant Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Sci Rep. 2024 Dec 28;14(1):31487. doi: 10.1038/s41598-024-83320-8.
Central body fat distribution affects kidney function. Abdominal fat measurements using computed tomography (CT) may prove superior in assessing body composition-related kidney risk in living kidney donors. This retrospective cohort study including 550 kidney donors aimed to determine the association between CT-measured abdominal fat areas and kidney function before and after donor nephrectomy. Donors underwent glomerular filtration rate measurements (I-Iothalamate, mGFR) before and 3 months after donation. Linear regression analyses with body surface area (BSA)-standardized and crude mGFR were performed to assess the association of height-indexed tomographic fat measurements with kidney function. In age-, and sex-adjusted analyses higher levels of total abdominal, visceral, subcutaneous, and intramuscular adipose tissue index were significantly associated with lower mGFR levels before donation (BSA-standardized mGFR: visceral adipose tissue index: Βeta=-0.11, p < 0.001, subcutaneous: Βeta=-0.10, p < 0.001, intramuscular: Βeta=-1.18, p < 0.001, total abdominal: Βeta=-0.07, p < 0.001). Higher tomographic abdominal fat is associated with lower BSA-standardized mGFR after donation and a greater decrease in mGFR between screening and 3 months post-donation. This study shows that CT-measured abdominal fat area is associated with kidney function before and after living kidney donation.
中心性体脂分布影响肾功能。使用计算机断层扫描（CT）测量腹部脂肪可能在评估活体肾供体中与身体组成相关的肾脏风险方面更具优势。这项纳入550名肾供体的回顾性队列研究旨在确定CT测量的腹部脂肪面积与供肾切除术前、后的肾功能之间的关联。供体在捐献前和捐献后3个月接受肾小球滤过率测量（碘他拉酸盐，mGFR）。进行了体表面积（BSA）标准化和未标准化的mGFR的线性回归分析，以评估身高指数化的断层脂肪测量与肾功能之间的关联。在年龄和性别调整分析中，较高水平的腹部总脂肪、内脏脂肪、皮下脂肪和肌内脂肪组织指数与捐献前较低的mGFR水平显著相关（BSA标准化mGFR：内脏脂肪组织指数：β=-0.11，p<0.001；皮下脂肪：β=-0.10，p<0.001；肌内脂肪：β=-1.18，p<0.001；腹部总脂肪：β=-0.07，p<0.001）。较高的断层腹部脂肪与捐献后较低的BSA标准化mGFR以及筛查至捐献后3个月期间mGFR的更大下降相关。这项研究表明，CT测量的腹部脂肪面积与活体肾捐献前后的肾功能相关。
