Skip to main content
Top
Published in: Magnetic Resonance Materials in Physics, Biology and Medicine 1/2020

Open Access 01-02-2020 | Hypertension | Research Article

Renal sinus fat and renal hemodynamics: a cross-sectional analysis

Authors: Karlinde A. Spit, Marcel H. A. Muskiet, Lennart Tonneijck, Mark M. Smits, Mark H. H. Kramer, Jaap A. Joles, Anneloes de Boer, Daniel H. van Raalte

Published in: Magnetic Resonance Materials in Physics, Biology and Medicine | Issue 1/2020

Login to get access

Abstract

Objectives

Increased renal sinus fat (RSF) is associated with hypertension and chronic kidney disease, but underlying mechanisms are incompletely understood. We evaluated relations between RSF and gold-standard measures of renal hemodynamics in type 2 diabetes (T2D) patients.

Methods

Fifty-one T2D patients [age 63 ± 7 years; BMI 31 (28–34) kg/m2; GFR 83 ± 16 mL/min/1.73 m2] underwent MRI-scanning to quantify RSF volume, and subcutaneous and visceral adipose tissue compartments (SAT and VAT, respectively). GFR and effective renal plasma flow (ERPF) were determined by inulin and PAH clearances, respectively. Effective renal vascular resistance (ERVR) was calculated.

Results

RSF correlated negatively with GFR (r = − 0.38; p = 0.006) and ERPF (r = − 0.38; p = 0.006) and positively with mean arterial pressure (MAP) (r = 0.29; p = 0.039) and ERVR (r = 0.45, p = 0.001), which persisted after adjustment for VAT, MAP, sex, and BMI. After correction for age, ERVR remained significantly related to RSF.

Conclusions

In T2D patients, higher RSF volume was negatively associated to GFR. In addition, RSF volume was positively associated with increased renal vascular resistance, which may mediate hypertension and CKD development. Further research is needed to investigate how RSF may alter the (afferent) vascular resistance of the renal vasculature.
Appendix
Available only for authorised users
Literature
1.
go back to reference Després JP (2012) Body fat distribution and risk of cardiovascular disease: an update. Circulation 126:1301–1313CrossRefPubMed Després JP (2012) Body fat distribution and risk of cardiovascular disease: an update. Circulation 126:1301–1313CrossRefPubMed
2.
go back to reference Foster MC, Hwang SJ, Larson MG, Lichtman JH, Parikh NI, Vasan RS et al (2008) Overweight, obesity, and the development of stage 3 CKD: the framingham heart study. Am J Kidney Dis 52:39–48CrossRefPubMedPubMedCentral Foster MC, Hwang SJ, Larson MG, Lichtman JH, Parikh NI, Vasan RS et al (2008) Overweight, obesity, and the development of stage 3 CKD: the framingham heart study. Am J Kidney Dis 52:39–48CrossRefPubMedPubMedCentral
3.
go back to reference Montani JP, Carroll JF, Dwyer TM, Antic V, Yang Z, Dulloo AG (2004) Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes 28:S58CrossRef Montani JP, Carroll JF, Dwyer TM, Antic V, Yang Z, Dulloo AG (2004) Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes 28:S58CrossRef
4.
go back to reference Hajer GR, Van Haeften TW, Visseren FLJ (2008) Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 29:2959–2971CrossRefPubMed Hajer GR, Van Haeften TW, Visseren FLJ (2008) Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 29:2959–2971CrossRefPubMed
5.
go back to reference Artunc F, Schleicher E, Weigert C, Fritsche A, Stefan N, Häring HU (2016) The impact of insulin resistance on the kidney and vasculature. Nat Rev Nephrol 12:721CrossRefPubMed Artunc F, Schleicher E, Weigert C, Fritsche A, Stefan N, Häring HU (2016) The impact of insulin resistance on the kidney and vasculature. Nat Rev Nephrol 12:721CrossRefPubMed
6.
go back to reference De Vries APJ, Ruggenenti P, Ruan XZ, Praga M, Cruzado JM, Bajema IM et al (2014) Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol 2:417–426CrossRefPubMed De Vries APJ, Ruggenenti P, Ruan XZ, Praga M, Cruzado JM, Bajema IM et al (2014) Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol 2:417–426CrossRefPubMed
7.
go back to reference Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS (2011) Fatty kidney, hypertension, and chronic kidney disease: the framingham heart study. Hypertension 58:784–790CrossRefPubMed Foster MC, Hwang SJ, Porter SA, Massaro JM, Hoffmann U, Fox CS (2011) Fatty kidney, hypertension, and chronic kidney disease: the framingham heart study. Hypertension 58:784–790CrossRefPubMed
8.
go back to reference Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L et al (2011) 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 26:892–898CrossRefPubMed Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L et al (2011) 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 26:892–898CrossRefPubMed
9.
go back to reference Chughtai HL, Morgan TM, Rocco M, Stacey B, Brinkley TE, Ding J et al (2010) Renal sinus fat and poor blood pressure control in middle-aged and elderly individuals at risk for cardiovascular events. Hypertension 56:901–906CrossRefPubMed Chughtai HL, Morgan TM, Rocco M, Stacey B, Brinkley TE, Ding J et al (2010) Renal sinus fat and poor blood pressure control in middle-aged and elderly individuals at risk for cardiovascular events. Hypertension 56:901–906CrossRefPubMed
10.
go back to reference Wagner R, MaChann J, Lehmann R, Rittig K, Schick F, Lenhart J et al (2012) Exercise-induced albuminuria is associated with perivascular renal sinus fat in individuals at increased risk of type 2 diabetes. Diabetologia 55:2054–2058CrossRefPubMed Wagner R, MaChann J, Lehmann R, Rittig K, Schick F, Lenhart J et al (2012) Exercise-induced albuminuria is associated with perivascular renal sinus fat in individuals at increased risk of type 2 diabetes. Diabetologia 55:2054–2058CrossRefPubMed
11.
12.
go back to reference Siegel-Axel DI, Häring HU (2016) Perivascular adipose tissue: an unique fat compartment relevant for the cardiometabolic syndrome. Rev Endocr Metab Disord 17:51–60CrossRefPubMed Siegel-Axel DI, Häring HU (2016) Perivascular adipose tissue: an unique fat compartment relevant for the cardiometabolic syndrome. Rev Endocr Metab Disord 17:51–60CrossRefPubMed
14.
go back to reference Eringa EC, Bakker W, van Hinsbergh VWM (2012) Paracrine regulation of vascular tone, inflammation and insulin sensitivity by perivascular adipose tissue. Vasc Pharmacol 56:204–209CrossRef Eringa EC, Bakker W, van Hinsbergh VWM (2012) Paracrine regulation of vascular tone, inflammation and insulin sensitivity by perivascular adipose tissue. Vasc Pharmacol 56:204–209CrossRef
15.
go back to reference Restini CBA, Ismail A, Kumar RK, Burnett R, Garver H, Fink GD et al (2018) Renal perivascular adipose tissue: form and function. Vasc Pharmacol 106:37–45CrossRef Restini CBA, Ismail A, Kumar RK, Burnett R, Garver H, Fink GD et al (2018) Renal perivascular adipose tissue: form and function. Vasc Pharmacol 106:37–45CrossRef
16.
go back to reference Meijer RI, Serne EH, Smulders YM, Van Hinsbergh VWM, Yudkin JS, Eringa EC (2011) Perivascular adipose tissue and its role in type 2 diabetes and cardiovascular disease. Curr Diabetes Rep 11:211–217CrossRef Meijer RI, Serne EH, Smulders YM, Van Hinsbergh VWM, Yudkin JS, Eringa EC (2011) Perivascular adipose tissue and its role in type 2 diabetes and cardiovascular disease. Curr Diabetes Rep 11:211–217CrossRef
17.
go back to reference Smits MM, Tonneijck L, Muskiet MHA, Hoekstra T, Kramer MHH, Pieters IC et al (2015) Cardiovascular, renal and gastrointestinal effects of incretin-based therapies: an acute and 12-week randomised, double-blind, placebo-controlled, mechanistic intervention trial in type 2 diabetes. BMJ Open 5:e009579CrossRefPubMedPubMedCentral Smits MM, Tonneijck L, Muskiet MHA, Hoekstra T, Kramer MHH, Pieters IC et al (2015) Cardiovascular, renal and gastrointestinal effects of incretin-based therapies: an acute and 12-week randomised, double-blind, placebo-controlled, mechanistic intervention trial in type 2 diabetes. BMJ Open 5:e009579CrossRefPubMedPubMedCentral
18.
go back to reference Tonneijck L, Smits MM, Muskiet MHA, Hoekstra T, Kramer MHH, Danser AHJ et al (2016) Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial. Diabetologia 59(7):1412–1421CrossRefPubMedPubMedCentral Tonneijck L, Smits MM, Muskiet MHA, Hoekstra T, Kramer MHH, Danser AHJ et al (2016) Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial. Diabetologia 59(7):1412–1421CrossRefPubMedPubMedCentral
19.
go back to reference Tonneijck L, Smits MM, Muskiet MHA, Hoekstra T, Kramer MHH, Danser AHJ et al (2016) Renal effects of DPP-4 inhibitor sitagliptin or GLP-1 receptor agonist liraglutide in overweight patients with type 2 diabetes: a 12-week, randomized, double-blind, placebo-controlled trial. Diabetes Care 39:2042–2050CrossRefPubMed Tonneijck L, Smits MM, Muskiet MHA, Hoekstra T, Kramer MHH, Danser AHJ et al (2016) Renal effects of DPP-4 inhibitor sitagliptin or GLP-1 receptor agonist liraglutide in overweight patients with type 2 diabetes: a 12-week, randomized, double-blind, placebo-controlled trial. Diabetes Care 39:2042–2050CrossRefPubMed
20.
go back to reference Foster MC, Hwang S, Porter SA, Massaro JM, Hoffmann U, Fox CS (2011) Development and reproducibility of a computed tomography-based measurement of renal sinus fat. BMC Nephrol 12:52CrossRefPubMedPubMedCentral Foster MC, Hwang S, Porter SA, Massaro JM, Hoffmann U, Fox CS (2011) Development and reproducibility of a computed tomography-based measurement of renal sinus fat. BMC Nephrol 12:52CrossRefPubMedPubMedCentral
21.
go back to reference Caglar V, Songur A, Acar M, Uygur R, Alkoc OA, Acar T (2014) Volumetric evaluation of fat in the renal sinus in normal subjects using stereological method on computed tomography images and its relationship with body composition. Folia Morphol 73:302–308CrossRef Caglar V, Songur A, Acar M, Uygur R, Alkoc OA, Acar T (2014) Volumetric evaluation of fat in the renal sinus in normal subjects using stereological method on computed tomography images and its relationship with body composition. Folia Morphol 73:302–308CrossRef
22.
go back to reference Krievina G, Tretjakovs P, Skuja I, Silina V, Keisa L, Krievina D et al (2016) Ectopic adipose tissue storage in the left and the right renal sinus is asymmetric and associated with serum kidney injury molecule-1 and fibroblast growth factor-21 levels increase. EBioMedicine 13:274–283CrossRefPubMedPubMedCentral Krievina G, Tretjakovs P, Skuja I, Silina V, Keisa L, Krievina D et al (2016) Ectopic adipose tissue storage in the left and the right renal sinus is asymmetric and associated with serum kidney injury molecule-1 and fibroblast growth factor-21 levels increase. EBioMedicine 13:274–283CrossRefPubMedPubMedCentral
23.
go back to reference Gæde P, Tarnow L, Vedel P, Parving HH, Pedersen O (2004) Remission to normoalbuminuria during multifactorial treatment preserves kidney function in patients with type 2 diabetes and microalbuminuria. Nephrol Dial Transplant 19:2784–2788CrossRefPubMed Gæde P, Tarnow L, Vedel P, Parving HH, Pedersen O (2004) Remission to normoalbuminuria during multifactorial treatment preserves kidney function in patients with type 2 diabetes and microalbuminuria. Nephrol Dial Transplant 19:2784–2788CrossRefPubMed
25.
go back to reference Hall J (2003) Mechanisms of abnormal renal sodium handling in obesity hypertension*1. Am J Hypertens 10:49S–55SCrossRef Hall J (2003) Mechanisms of abnormal renal sodium handling in obesity hypertension*1. Am J Hypertens 10:49S–55SCrossRef
26.
go back to reference Doi Y, Iwashima Y, Yoshihara F, Kamide K, Hayashi SI, Kubota Y et al (2012) Renal resistive index and cardiovascular and renal outcomes in essential hypertension. Hypertension 60:770–777CrossRefPubMed Doi Y, Iwashima Y, Yoshihara F, Kamide K, Hayashi SI, Kubota Y et al (2012) Renal resistive index and cardiovascular and renal outcomes in essential hypertension. Hypertension 60:770–777CrossRefPubMed
27.
go back to reference Zelicha H, Schwarzfuchs D, Shelef I, Gepner Y, Tsaban G, Tene L et al (2018) Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial. Clin Nutr 37:1145–1153CrossRefPubMed Zelicha H, Schwarzfuchs D, Shelef I, Gepner Y, Tsaban G, Tene L et al (2018) Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial. Clin Nutr 37:1145–1153CrossRefPubMed
Metadata
Title
Renal sinus fat and renal hemodynamics: a cross-sectional analysis
Authors
Karlinde A. Spit
Marcel H. A. Muskiet
Lennart Tonneijck
Mark M. Smits
Mark H. H. Kramer
Jaap A. Joles
Anneloes de Boer
Daniel H. van Raalte
Publication date
01-02-2020
Publisher
Springer International Publishing
Published in
Magnetic Resonance Materials in Physics, Biology and Medicine / Issue 1/2020
Print ISSN: 0968-5243
Electronic ISSN: 1352-8661
DOI
https://doi.org/10.1007/s10334-019-00773-z

Other articles of this Issue 1/2020

Magnetic Resonance Materials in Physics, Biology and Medicine 1/2020 Go to the issue