The Utility of Perirenal Fat in Determining the Risk of Onset and Progression of Diabetic Kidney Disease

Hongtu Hu; Wei Liang; Zongwei Zhang; Zikang Liu; Fan Chu; Yan Bao; Jialu Ran; Guohua Ding

doi:10.1155/2022/2550744

The Utility of Perirenal Fat in Determining the Risk of Onset and Progression of Diabetic Kidney Disease

Int J Endocrinol. 2022 Nov 30:2022:2550744. doi: 10.1155/2022/2550744. eCollection 2022.

Authors

Hongtu Hu^{1

2}, Wei Liang^{1

2}, Zongwei Zhang^{1

2}, Zikang Liu^{1

2}, Fan Chu^{1

2}, Yan Bao³, Jialu Ran⁴, Guohua Ding^{1

2}

Affiliations

¹ Division of Nephrology, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei 430060, China.
² Key Clinical Research Center of Kidney Disease, 238 Jiefang Rd, Wuhan, Hubei 430060, China.
³ Division of Endocrinology, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, Hubei 430060, China.
⁴ Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, Georgia 30322, USA.

Abstract

Background: Perirenal fat (PRF) has multiple effects on the kidney through its physical structure and adipocytokine-secreting ability. The present study explored the relationship between PRF thickness and the onset and progression of albuminuria in patients with diabetes.

Methods: In the cross-sectional analysis, we screened 959 patients from 8764 subjects with type 2 diabetes mellitus (T2DM) who met the inclusion criteria and measured their perirenal fat thickness (PFT) using color Doppler ultrasound. A group of laboratory indexes were included in the analysis models. In a longitudinal study, a total of 218 patients with a baseline UACR <30 mg/g were included in the follow-up study.

Results: In a cross-sectional analysis, patients with diabetes and higher PFT presented with higher albuminuria. Multiple logistic regression analysis indicated that PFT was an independent risk factor for the degree of albuminuria in patients with T2DM (odds ratio = 4.186, 95%CI: 2.290-7.653, P < 0.001). In a longitudinal study, 218 albuminuria-free patients with T2DM at the baseline were followed up for a mean of 12.3 months. Based on the cutoff value from the ROC diagnostic test in the cross-sectional study, patients were divided into two groups: higher PFT (H-PFT) and lower PFT (L-PFT). Kaplan-Meier survival curve analysis showed that H-PFT was associated with a higher incidence of albuminuria than L-PFT (log-rank test, χ2 = 4.522, P = 0.033). Cox regression analysis showed that PFT was a risk factor for the earlier onset of albuminuria (hazard ratio 2.83, 95% CI: 1.34-4.88, P < 0.001).

Conclusions: PRF evaluated by color Doppler ultrasound is an easy and reliable tool for predicting the onset and progression of albuminuria in patients with T2DM.