Abdominal adipose tissue and type 2 diabetic kidney disease: adipose radiology assessment, impact, and mechanisms

Abdom Radiol (NY). 2024 Feb;49(2):560-574. doi: 10.1007/s00261-023-04062-1. Epub 2023 Oct 17.

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.

Keywords: Abdominal fat; Diabetic kidney disease; Radiology assessment; Type 2 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Abdominal Fat / diagnostic imaging
  • Adiposity
  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Nephropathies* / diagnostic imaging
  • Humans
  • Obesity
  • Obesity, Abdominal