Endocrinol Metab.  2020 Mar;35(1):122-131. 10.3803/EnM.2020.35.1.122.

Associations of Perirenal Fat Thickness with Renal and Systemic Calcified Atherosclerosis

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. bokyungkoomd@gmail.com
  • 2Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
  • 3Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.

Abstract

BACKGROUND
We investigated associations between perirenal fat thickness and atherosclerotic calcification in six different vascular beds.
METHODS
Using a community-based cohort (n=3,919), perirenal fat thickness was estimated from computed tomography scans. It was classified as Q1 (the lowest quartile) to Q4 (the highest quartile) in each sex. Calcification in the carotid arteries, coronary arteries, thoracic aorta, abdominal aorta, iliac arteries, and renal arteries was evaluated.
RESULTS
Perirenal fat thickness was associated with older age (P<0.01) and a higher prevalence of obesity, hypertension, and dyslipidemia (P<0.01 for all). Perirenal fat thickness was independently associated with renal arterial calcification even after adjustment for age, sex, body mass index, hypertension, dyslipidemia, smoking history, and family history of heart diseases in first-degree relatives (odds ratio [OR] per quartile of perirenal fat thickness, 1.25; 95% confidence interval [CI], 1.09 to 1.44). Compared to Q1, the odds of renal arterial calcification in Q4 was about two times higher (OR, 2.05; 95% CI, 1.29 to 3.25). After adjustment for renal arterial calcification and atherosclerotic risk factors, the only other vascular bed where perirenal fat thickness showed a significant association with calcification was the abdominal aorta (OR, 1.11; 95% CI, 1.00 to 1.23; P=0.045).
CONCLUSION
Perirenal fat thickness was independently associated with vascular calcification in the renal artery and abdominal aorta.

Keyword

Atherosclerosis; Vascular calcification; Obesity; Renal artery; Aorta, abdominal

MeSH Terms

Aorta, Abdominal
Aorta, Thoracic
Atherosclerosis*
Body Mass Index
Carotid Arteries
Cohort Studies
Coronary Vessels
Dyslipidemias
Heart Diseases
Humans
Hypertension
Iliac Artery
Obesity
Prevalence
Renal Artery
Risk Factors
Smoke
Smoking
Vascular Calcification
Smoke

Figure

  • Fig. 1 The risk of arterial calcification according to the quartiles of perirenal fat thickness. Total perirenal fat thickness was defined as the sum of perirenal fat thickness of both sides, and it was classified as Q1 (the lowest quartile) to Q4 (the highest quartile). Odds ratios (ORs) with 95% confidence interval (CIs) of the calcification in each arterial bed according to the perirenal fat thickness are shown (A) in the entire population, (B) those without renal artery calcification, and (C) in those with renal artery calcification. All statistical values were adjusted for age, sex, body mass index, hypertension, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, smoking history, and family history of heart disease in first-degree relatives. RACS, renal artery calcification score. aP<0.05 compared to Q1; bP<0.005 compared to Q1; cP for trend.


Reference

1. Byrne CD, Targher G. NAFLD: a multisystem disease. J Hepatol. 2015; 62(1 Suppl):S47–S64. PMID: 25920090.
Article
2. Meshkani R, Adeli K. Hepatic insulin resistance, metabolic syndrome and cardiovascular disease. Clin Biochem. 2009; 42:1331–1346. PMID: 19501581.
Article
3. Komiya H, Mori Y, Yokose T, Kurokawa N, Horie N, Tajima N. Effect of intramuscular fat difference on glucose and insulin reaction in oral glucose tolerance test. J Atheroscler Thromb. 2006; 13:136–142. PMID: 16835468.
Article
4. Therkelsen KE, Pedley A, Speliotes EK, Massaro JM, Murabito J, Hoffmann U, et al. Intramuscular fat and associations with metabolic risk factors in the Framingham Heart Study. Arterioscler Thromb Vasc Biol. 2013; 33:863–870. PMID: 23349188.
Article
5. Krssak M, Roden M. The role of lipid accumulation in liver and muscle for insulin resistance and type 2 diabetes mellitus in humans. Rev Endocr Metab Disord. 2004; 5:127–134. PMID: 15041788.
Article
6. Tilg H, Hotamisligil GS. Nonalcoholic fatty liver disease: cytokine-adipokine interplay and regulation of insulin resistance. Gastroenterology. 2006; 131:934–945. PMID: 16952562.
Article
7. Wieckowska A, Papouchado BG, Li Z, Lopez R, Zein NN, Feldstein AE. Increased hepatic and circulating interleukin-6 levels in human nonalcoholic steatohepatitis. Am J Gastroenterol. 2008; 103:1372–1379. PMID: 18510618.
Article
8. Lim S, Meigs JB. Links between ectopic fat and vascular disease in humans. Arterioscler Thromb Vasc Biol. 2014; 34:1820–1826. PMID: 25035342.
Article
9. Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med. 2010; 363:1341–1350. PMID: 20879883.
Article
10. Koo BK, Allison MA, Criqui MH, Denenberg JO, Wright CM. The association between liver fat and systemic calcified atherosclerosis. J Vasc Surg. 2020; 71:204–211. PMID: 31153702.
Article
11. Chau YY, Bandiera R, Serrels A, Martinez-Estrada OM, Qing W, Lee M, et al. Visceral and subcutaneous fat have different origins and evidence supports a mesothelial source. Nat Cell Biol. 2014; 16:367–375. PMID: 24609269.
Article
12. Roever L, Resende ES, Veloso FC, Diniz AL, Penha-Silva N, Casella-Filho A, et al. Perirenal fat and association with metabolic risk factors: the Uberlandia Heart Study. Medicine (Baltimore). 2015; 94:e1105.
13. De Pergola G, Campobasso N, Nardecchia A, Triggiani V, Caccavo D, Gesualdo L, et al. Para- and perirenal ultrasonographic fat thickness is associated with 24-hours mean diastolic blood pressure levels in overweight and obese subjects. BMC Cardiovasc Disord. 2015; 15:108. PMID: 26419359.
Article
14. Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L, et al. 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. 2011; 26:892–898. PMID: 20798120.
Article
15. Dwyer TM, Mizelle HL, Cockrell K, Buhner P. Renal sinus lipomatosis and body composition in hypertensive, obese rabbits. Int J Obes Relat Metab Disord. 1995; 19:869–874. PMID: 8963354.
16. Spit KA, Muskiet MH, Tonneijck L, Smits MM, Kramer MH, Joles JA, et al. Renal sinus fat and renal hemodynamics: a cross-sectional analysis. MAGMA. 2020; 33:73–80. PMID: 31471702.
Article
17. Favre G, Grangeon-Chapon C, Raffaelli C, Francois-Chalmin F, Iannelli A, Esnault V. Perirenal fat thickness measured with computed tomography is a reliable estimate of perirenal fat mass. PLoS One. 2017; 12:e0175561. PMID: 28423008.
Article
18. Shulman GI. Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. N Engl J Med. 2014; 371:1131–1141. PMID: 25229917.
Article
19. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med. 1998; 158:1855–1867. PMID: 9759681.
20. Allison MA, Criqui MH, Wright CM. Patterns and risk factors for systemic calcified atherosclerosis. Arterioscler Thromb Vasc Biol. 2004; 24:331–336. PMID: 14656730.
Article
21. Hughes-Austin JM, Dominguez A 3rd, Allison MA, Wassel CL, Rifkin DE, Morgan CG, et al. Relationship of coronary calcium on standard chest CT scans with mortality. JACC Cardiovasc Imaging. 2016; 9:152–159. PMID: 26777213.
Article
22. Lin TC, Wright CM, Criqui MH, Allison MA. Superior mesenteric artery calcification is associated with cardiovascular risk factors, systemic calcified atherosclerosis, and increased mortality. J Vasc Surg. 2018; 67:1484–1490. PMID: 29103930.
Article
23. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990; 15:827–832. PMID: 2407762.
Article
24. Eisner BH, Zargooshi J, Berger AD, Cooperberg MR, Doyle SM, Sheth S, et al. Gender differences in subcutaneous and perirenal fat distribution. Surg Radiol Anat. 2010; 32:879–882. PMID: 20607260.
Article
25. Hervochon R, Bobbio A, Guinet C, Mansuet-Lupo A, Rabbat A, Regnard JF, et al. Body mass index and total psoas area affect outcomes in patients undergoing pneumonectomy for cancer. Ann Thorac Surg. 2017; 103:287–295. PMID: 27659598.
Article
26. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. Upper Saddle River: Prentice Hall Health;2000.
27. Rifkin DE, Ix JH, Wassel CL, Criqui MH, Allison MA. Renal artery calcification and mortality among clinically asymptomatic adults. J Am Coll Cardiol. 2012; 60:1079–1085. PMID: 22939556.
Article
28. Wu H, Cheng XW, Hao C, Zhang Z, Yao H, Murohara T, et al. Regulation of apelin and its receptor expression in adipose tissues of obesity rats with hypertension and cultured 3T3-L1 adipocytes. Exp Anim. 2014; 63:257–267. PMID: 24770651.
29. Kwon EY, Shin SK, Cho YY, Jung UJ, Kim E, Park T, et al. Time-course microarrays reveal early activation of the immune transcriptome and adipokine dysregulation leads to fibrosis in visceral adipose depots during diet-induced obesity. BMC Genomics. 2012; 13:450. PMID: 22947075.
Article
30. Hoogduijn MJ, Crop MJ, Peeters AM, van Osch GJ, Balk AH, Ijzermans JN, et al. Human heart, spleen, and perirenal fat-derived mesenchymal stem cells have immunomodulatory capacities. Stem Cells Dev. 2007; 16:597–604. PMID: 17784833.
Article
31. Niijima A. Reflex effects from leptin sensors in the white adipose tissue of the epididymis to the efferent activity of the sympathetic and vagus nerve in the rat. Neurosci Lett. 1999; 262:125–128. PMID: 10203247.
Article
32. Liu BX, Sun W, Kong XQ. Perirenal fat: a unique fat pad and potential target for cardiovascular disease. Angiology. 2019; 70:584–593. PMID: 30301366.
Article
33. Chughtai HL, Morgan TM, Rocco M, Stacey B, Brinkley TE, Ding J, et al. Renal sinus fat and poor blood pressure control in middle-aged and elderly individuals at risk for cardiovascular events. Hypertension. 2010; 56:901–906. PMID: 20837881.
Article
34. Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS. Fatty kidney, hypertension, and chronic kidney disease: the Framingham Heart Study. Hypertension. 2011; 58:784–790. PMID: 21931075.
35. Lemieux I, Lamarche B, Couillard C, Pascot A, Cantin B, Bergeron J, et al. Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study. Arch Intern Med. 2001; 161:2685–2692. PMID: 11732933.
36. Lamarche B, Moorjani S, Lupien PJ, Cantin B, Bernard PM, Dagenais GR, et al. Apolipoprotein A-I and B levels and the risk of ischemic heart disease during a five-year follow-up of men in the Quebec cardiovascular study. Circulation. 1996; 94:273–278. PMID: 8759066.
Article
37. Cui Y, Blumenthal RS, Flaws JA, Whiteman MK, Langenberg P, Bachorik PS, et al. Non-high-density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality. Arch Intern Med. 2001; 161:1413–1419. PMID: 11386890.
Article
Full Text Links
  • ENM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr