Abstract
Purpose
To determine whether para- and perirenal fat ultrasonographic thickness (PFUT) is related to increased urinary albumin excretion and whether PFUT is an independent indicator of early kidney damage in obese subjects.
Method
Sixty-seven nonhypertensive, nondiabetic obese patients and 34 age- and sex-matched normal healthy volunteers were involved in this study. Clinical characteristics, blood biochemistry, PFUT, and urinary albumin/creatinine ratio (ACR) of the subjects were measured. The intraoperator and interoperator coefficient of variation was 5.6 and 3.2 %, respectively.
Results
ACR and PFUT were significantly higher in obese patients than those of normal healthy volunteers. PFUT was higher in obese patients with microalbuminuria than those with normoalbuminuria. Correlation analysis showed PFUT had a positive correlation with body mass index (BMI, r = 0.677, P < 0.01), waist circumference (WC, r = 0.686, P < 0.01), plasma free fatty acids (FFAs, r = 0.589, P < 0.01), and ACR (r = 0.610, P < 0.01). ACR had a positive correlation with BMI (r = 0.444, P < 0.01), WC (r = 0.440, P < 0.01), and plasma FFAs (r = 0.496, P < 0.01). Multivariate regression analyses showed that ACR could be predicted by PFUT.
Conclusions
PFUT may be an independent predictor of early kidney damage in nonhypertensive, nondiabetic obese patients, and PFUT could be a useful tool for the assessment of visceral fat and early kidney damage in obese patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kawar B, Bello AK, El NAM (2009) High prevalence of microalbuminuria in the overweight and obese population: data from a UK population screening programme. Nephron Clin Pract 112(3):c205–c212
Weisinger JR, Kempson RL, Eldridge FL, Swenson RS (1974) The nephrotic syndrome: a complication of massive obesity. Ann Intern Med 81(4):440–447
Zimering MB, Anderson RJ, Ge L, Moritz TE (2011) Increased plasma basic fibroblast growth factor is associated with coronary heart disease in adult type 2 diabetes mellitus. Metabolism 60(2):284–291
de Jong PE, Verhave JC, Pinto-Sietsma SJ, Hillege HL (2002) Obesity and target organ damage: the kidney. Int J Obes Relat Metab Disord 26(Suppl 4):S21–S24
Foster MC, Hwang SJ, Massaro JM, Hoffmann U, Deboer IH, Robins SJ et al (2011) Association of subcutaneous and visceral adiposity with albuminuria: the framingham heart study. Obesity (Silver Spring) 19(6):1284–1289
Tamba S, Nakatsuji H, Kishida K, Noguchi M, Ogawa T, Okauchi Y et al (2010) Relationship between visceral fat accumulation and urinary albumin-creatinine ratio in middle-aged Japanese men. Atherosclerosis 211(2):601–605
Noori N, Hosseinpanah F, Nasiri AA, Azizi F (2009) Comparison of overall obesity and abdominal adiposity in predicting chronic kidney disease incidence among adults. J Ren Nutr 19(3):228–237
Stallone DD, Stunkard AJ, Wadden TA, Foster GD, Boorstein J, Arger P (1991) Weight loss and body fat distribution: a feasibility study using computedtomography. Int J Obes 15(11):775–780
Tokunaga K, Matsuzawa Y, Ishikawa K, Tarui S (1983) A novel technique for the determination of body fat by computed tomography. Int J Obes 7(5):437–445
Sohlstrom A, Wahlund LO, Forsum E (1993) Adipose tissue distribution as assessed by magnetic resonance imaging and totalbody fat by magnetic resonance imaging, underwater weighing, and body-waterdilution in healthy women. Am J Clin Nutr 58(6):830–838
Vogt FM, Ruehm S, Hunold P, de Greiff A, Nuefer M, Barkhausen J et al (2007) Rapid total body fat measurement by magnetic resonance imaging: quantificationand topography. Rofo 179(5):480–486
Kirkland JL, Dobson DE (1997) Preadipocyte function and aging: links between age-related changes in celldynamics and altered fat tissue function. J Am Geriatr Soc 45(8):959–967
Armellini F, Zamboni M, Rigo L, Todesco T, Bergamo-Andreis IA, Procacci C et al (1990) The contribution of sonography to the measurement of intra-abdominal fat. J Clin Ultrasound 18(7):563–567
Kawasaki S, Aoki K, Hasegawa O, Numata K, Tanaka K, Shibata N et al (2008) Sonographic evaluation of visceral fat by measuring para- and perirenal fat. J Clin Ultrasound 36(3):129–133
Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L et al (2011) Para- and perirenal fat thickness is an independent predictor of chronic kidney disease, increased renal resistance index and hyperuricaemia in type-2 diabetic patients. Nephrol Dial Transplant 26(3):892–898
Organization WH (2000) The Asia-Pacific perspective: redefining obesity and its treatment. WHO 20, Geneva
Gatling W, Knight C, Mullee MA, Hill RD (1988) Microalbuminuria in diabetes: a population study of the prevalence and anassessment of three screening tests. Diabet Med 5(4):343–347
Pan XR, Yang WY, Li GW, Liu J (1997) Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group. Diabetes Care 20(11):1664–1669
Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD (2001) Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 59(4):1498–1509
Yasui K, Sumida Y, Mori Y, Mitsuyoshi H, Minami M, Itoh Y et al (2011) Nonalcoholic steatohepatitis and increased risk of chronic kidney disease. Metabolism 60(5):735–739
Klausen KP, Parving HH, Scharling H, Jensen JS (2009) Microalbuminuria and obesity: impact on cardiovascular disease and mortality. Clin Endocrinol (Oxf) 71(1):40–45
Han F, Hou N, Miao W, Sun X (2012) Correlation of ultrasonographic measurement of intrarenal arterial resistance index with microalbuminuria in nonhypertensive, nondiabetic obese patients. Int Urol Nephrol. doi:10.1007/s11255-012-0300-3
Bonnet F, Marre M, Halimi JM, Stengel B, Lange C, Laville M et al (2006) Larger waist circumference is a predictive factor for the occurrence of microalbuminuria in a non-diabetic population. Arch Mal Coeur Vaiss 99(7–8):660–662
Pinto-Sietsma SJ, Navis G, Janssen WM, de Zeeuw D, Gans RO, de Jong PE (2003) A central body fat distribution is related to renal function impairment, even in lean subjects. Am J Kidney Dis 41(4):733–741
Gong W, Ren H, Tong H, Shen X, Luo J, Chen S et al (2007) A comparison of ultrasound and magnetic resonance imaging to assess visceral fat in the metabolic syndrome. Asia Pac J Clin Nutr 16(Suppl 1):339–345
Koda M, Senda M, Kamba M, Kimura K, Murawaki Y (2007) Sonographic subcutaneous and visceral fat indices represent the distribution of body fat volume. Abdom Imaging 32(3):387–392
Suzuki R, Watanabe S, Hirai Y, Akiyama K, Nishide T, Matsushima Y et al (1993) Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen. Am J Med 95(3):309–314
Rea DJ, Heimbach JK, Grande JP, Textor SC, Taler SJ, Prieto M et al (2006) Glomerular volume and renal histology in obese and non-obese living kidney donors. Kidney Int 70(9):1636–1641
Acknowledgments
We would like to thank Dr. Junfang Xu from Center for Diseases Control and Prevention of Jingmen in China for the assistance in statistics. This study was supported by the Science and Technology Innovation Fund of Affiliated Hospital of Weifang Medical University (Grants Number: K12QC1004 and K12CX1007).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sun, X., Han, F., Miao, W. et al. Sonographic evaluation of para- and perirenal fat thickness is an independent predictor of early kidney damage in obese patients. Int Urol Nephrol 45, 1589–1595 (2013). https://doi.org/10.1007/s11255-013-0404-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-013-0404-4