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Lu F, Fan J, Li F, Liu L, Chen Z, Tian Z, Zuo L, Yu D. Abdominal adipose tissue and type 2 diabetic kidney disease: adipose radiology assessment, impact, and mechanisms. Abdom Radiol (NY) 2024; 49:560-574. [PMID: 37847262 DOI: 10.1007/s00261-023-04062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Diabetic kidney disease (DKD) is a significant healthcare burden worldwide that substantially increases the risk of kidney failure and cardiovascular events. To reduce the prevalence of DKD, extensive research is being conducted to determine the risk factors and consequently implement early interventions. Patients with type 2 diabetes mellitus (T2DM) are more likely to be obese. Abdominal adiposity is associated with a greater risk of kidney damage than general obesity. Abdominal adipose tissue can be divided into different fat depots according to the location and function, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), perirenal adipose tissue (PAT), and renal sinus adipose tissue (RSAT), which can be accurately measured by radiology techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI). Abdominal fat depots may affect the development of DKD through different mechanisms, and radiologic abdominal adipose characteristics may serve as imaging indicators of DKD risk. This review will first describe the CT/MRI-based assessment of abdominal adipose depots and subsequently describe the current studies on abdominal adipose tissue and DKD development, as well as the underlying mechanisms in patients of T2DM with DKD.
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Affiliation(s)
- Fei Lu
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Jinlei Fan
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Fangxuan Li
- Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Lijing Liu
- Department of Imaging, Yantaishan Hospital, Yantai, 264001, Shandong, China
| | - Zhiyu Chen
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Ziyu Tian
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Liping Zuo
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China
| | - Dexin Yu
- School of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong, China.
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China.
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Yığman M, Tangal S. Effects of body fat components on early renal functions of individuals following kidney donation. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221109411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Obesity stands as a risk factor for the chronic kidney disease. The objective of this study was to investigate the relationship between early renal function following kidney donation and the measurements of body fat components. Methods: In total, 86 donors followed up for at least 6 months postoperatively were included. Height and weight measurements and results of laboratory analysis of all donors were recorded retrospectively. Visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), hepatic fat (HF), pancreatic fat (PF) and splenic fat (SF) measurements were performed, and pancreatic splenic fat fraction difference (P−S) and pancreatic splenic fat fraction ratio (P/S) were calculated by a radiologist using the records of preoperative computed tomography scans of donors. Results: The estimated glomerular filtration rate (eGFR), serum creatinine and spot urinary microalbumin/creatinine ratio values of the donors at the sixth month postoperatively were statistically different from those of the preoperative values ( p < 0.001). In addition, the individuals were divided into two categories based on the postoperative eGFR: ⩾ 60 mL/min/1.73 m2 and < 60 mL/min/1.73 m2. Age, low-density lipoprotein (LDL) level and VAT/SAT ratio were lower in group eGFR: ⩾ 60 ( p < 0.001, p = 0.03, p = 0.007, respectively). Age and VAT/SAT ratio were the parameters found to be affecting the eGFR significantly, and VAT/SAT ratio (0.729, 95% CI: 0.602–0.856, p = 0.007) had higher predictive value in receiver operating characteristic curve (ROC). Conclusion: Preoperative measurements of body fat components may provide significant information to predict postoperative renal functions of kidney donor candidates. Level of evidence: Not applicable.
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Affiliation(s)
- Metin Yığman
- Department of Urology, Faculty of Medicine, Dr. Ridvan Ege Hospital, Ufuk University, Turkey
| | - Semih Tangal
- Department of Urology, Faculty of Medicine, Dr. Ridvan Ege Hospital, Ufuk University, Turkey
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Pinar U, Mageau A, Renard Y, Rod X, Lebacle C, Barrou B, Zaidan M, Irani J, Bessede T. Pre-transplant morphometry by computed tomography scan and post-transplant dialysis risk in overweight or obese kidney transplant recipients. Int Urol Nephrol 2021; 53:2469-2475. [PMID: 34536192 DOI: 10.1007/s11255-021-02995-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/12/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Adipose distribution and sarcopenia could better assess kidney transplantation outcomes than body mass index (BMI) and have been poorly evaluated among obese and overweight recipients. We aimed to evaluate morphometric radiologic markers to predict post-operative dialysis within this population. METHODS We conducted a retrospective study including patients with a BMI > 25 kg/m2 undergoing kidney transplantation during 5 years. Subcutaneous adipose tissue surface (SAT), visceral adipose tissue surface (VAT), and psoas surface were measured on CT scans sections. A model predictive of post-transplantation dialysis was elaborated through a multivariable logistic regression and was compared to a model including only BMI. RESULTS Overall, 248 patients were included whom mean (SD) BMI and age were, respectively, 29.7 kg/m2 (3.6) and 56 years (12.7). Of them, 83 (33.5%) needed dialysis: 14 (5.7%) for primary kidney failure and 69 (27.8%) for delayed kidney function. On multivariable analysis, SAT, VAT and deceased donor were significantly associated with post-operative dialysis (respectively, OR [95%CI]:1.6 [1.1-2.6], 1.6[1.1-2.6], and 7.5 [1.6-56]). The area under the curve of this predictive model was 0.70 versus 0.64 for a BMI-based model. CONCLUSION High VAT and SAT were associated with post-transplantation dialysis. A predictive model based on these morphometrics could provide a better appreciation of graft recovery after transplantation among obese and overweight recipients. External validation is needed.
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Affiliation(s)
- Ugo Pinar
- Department of Urology and Transplantation Surgery, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, 78 rue du général Leclerc, Le Kremlin-Bicêtre, 94270, Paris, France.
| | - Arthur Mageau
- Department of Internal Medicine, Hôpital Henri Mondor, AP-HP, Université Paris Saclay, Créteil, 94010, Paris, France
| | - Yohann Renard
- Department of Visceral Surgery, Reims, Champagne-Ardenne University, Robert Debré University Hospital, Reims, France
| | - Xavier Rod
- Department of Urology and Kidney Transplantation, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, AP-HP. Sorbonne Université, 75013, Paris, France
| | - Cédric Lebacle
- Department of Urology and Transplantation Surgery, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, 78 rue du général Leclerc, Le Kremlin-Bicêtre, 94270, Paris, France
| | - Benoit Barrou
- Department of Urology and Kidney Transplantation, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, AP-HP. Sorbonne Université, 75013, Paris, France
| | - Mohamad Zaidan
- Department of Nephrology, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, Le Kremlin-Bicêtre, 94270, Paris, France
| | - Jacques Irani
- Department of Urology and Transplantation Surgery, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, 78 rue du général Leclerc, Le Kremlin-Bicêtre, 94270, Paris, France
| | - Thomas Bessede
- Department of Urology and Transplantation Surgery, Hôpital de Bicêtre, AP-HP. Université Paris Saclay, 78 rue du général Leclerc, Le Kremlin-Bicêtre, 94270, Paris, France.,U1195, Université Paris-Saclay, Inserm, Le Kremlin-Bicêtre, 94276, Paris, France
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Pek GXW, Tiong HY. Visceral Obesity in living kidney Asian donors - long term impact of renal function after donor nephrectomy. World J Urol 2020; 39:4505-4506. [PMID: 32897394 DOI: 10.1007/s00345-020-03427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - Ho Yee Tiong
- Department of Urology, National University Hospital, Singapore, Singapore.
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Yildiz BD. Donate or not to donate if with visceral obesity. World J Urol 2019; 38:249. [PMID: 30610357 DOI: 10.1007/s00345-018-02626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 12/31/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Baris D Yildiz
- Ankara Numune Teaching Hospital General Surgery, 06100, Sihhiye, Ankara, Turkey.
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