Association of Visceral and Subcutaneous Adiposity with Kidney Function

Abstract

Background and objectives: Obesity is a risk factor for incident chronic kidney disease (CKD). Visceral (VAT) and subcutaneous adipose tissue (SAT) may confer differential metabolic risk profiles. The relations of VAT and SAT were analyzed with CKD as estimated by creatinine-and cystatin-based estimating equations.Design, setting, participants, & measurements: Participants from the Framingham Offspring Study who underwent abdominal computed tomography for VAT and SAT quantification were included (n ‫؍‬ 1299; 53% women; mean age 60 yr). CKD was defined as estimated GFR <60 ml/min per 1.73 m 2 , as estimated using creatinine (n ‫؍‬ 89) in the Modification of Diet in Renal Disease (MDRD) formula or by cystatin C (n ‫؍‬ 136). Regression models evaluated the cross-sectional relations between VAT and SAT with CKD and cystatin C, with age and gender adjustment and cardiovascular risk factor adjustment.Results: Neither VAT nor SAT was associated with CKD as estimated by the MDRD equation. In contrast, both VAT and SAT were associated with CKD when defined using cystatin-based equations. The estimated decrease in estimated GFR by cystatin C per 1-SD increase of VAT was 1.9 ml/min per 1.73 m 2 and for SAT was 2.6 ml/min per 1.73 m 2 in a multivariableadjusted model.Conclusions: VAT and SAT were associated with CKD when defined using cystatin C estimating equations but not when using a creatinine-based estimating equation. Mechanisms linking adipose tissue to cystatin C warrant further research.

Intrahepatic triglyceride content is independently associated with chronic kidney disease in obese adults: A cross-sectional study

“…a Analysis is performed on log-transformed data. adiposity is associated with the incidence of CKD [31,32]. Our data show that the risk for abnormal albuminuria and CKD increases by 68% and 54% per 1 SD increase in IHTG content, which is independent of traditional cardio-metabolic risk factors, including insulin resistance, metabolic syndrome, and abdominal visceral fat.…”

Interpreting different measures of glomerular filtration rate in obesity and weight loss: pitfalls for the clinician

“…51 In this cohort with a mean age of 60±9 years, the prevalence of CKD (GFRo60 ml min À1 per 1.73 m 2 ) was 6.8% using MDRD GFR and 10.5% using cystatin C-based GFR. There was no association between visceral adipose tissue and subcutaneous adipose tissue and CKD as defined by MDRD as there was for cystatin-based equations.…”

Cystatin C in healthy middle-aged adults: A relationship with anthropometric and cardiometabolic parameters

“…Obesity is an independent risk factor for renal impairment, as showed by Chen et al (20) who reported that the risk for CKD was more than twice as high in patients with increased WC than in those without increased WC. Furthermore, Young et al (21) found that visceral and subcutaneous adipose tissue (as measured by computed tomography) were associated with CKD defined only with cystatin C estimating equations, but not when using a creatinine-based estimating equations.…”