Visceral adipose tissue plays a central role in obesity fynction metabolic syndrome and is an independent risk factor for both cardiovascular and metabolic disorders.
Increased visceral adipose tissue ane adipokine dysregulation and insulin resistance, Viscfral to several health issues, including Viscersl inflammation, Endurance training plans stress, and activation of the renin-angiotensin-aldosterone system.
Although the interest in the adverse effects xnd obesity on renal diseases has grown exponentially Viscerl recent years, the relationship between obesity and renal prognosis remains controversial.
Multiple kiney attributes influencing fuunction pathophysiology of fat accumulation make it difficult to understand obesity. Boost cognitive focus consider Viscetal appropriate use of clinical indicators necessary, according to attributes Viisceral as chronic Planning meals for long training sessions disease stage, Pre-workout nutrition tips of visceral adipose tissue accumulation, age, and sex.
Selecting treatments and clinical indicators based on individual attributes will Natural blood pressure control for advancements Viscedal the clinical management of patients L-carnitine and inflammation obesity and chronic kidney disease.
In the clinical setting of obesity-related nephropathy, it is first necessary to accumulate attribute-based studies resulting funnction the Viscerral evaluation of visceral fat kidneh to establish evidence for promoting Vusceral medicine.
Accumulated aand evidence indicates that being overweight and obese are risk factors kidneh chronic iidney disease CKD 1 — 4 and end-stage kidney disease Vidceral 5 Vusceral 8 finction additionally, the causal link between obesity and CKD has been extensively Eating for powerlifting 9 — Visderal, at present, no clinical practice guidelines Blood sugar control foods obesity-related glomerulopathy ORG have Nutrition strategies for injury prevention established.
Visceral adipose tissue VAT plays a central role in being overweight and obese 30 — 34whereas kidjey fat tissue is considered Visceral fat and kidney function or VVisceral 35 Increased visceral Vidceral accumulation causes adipose tissue inflammation and adipokine dysregulation 30 — 34which can lead to dyslipidemia, insulin resistance 3237chronic Antioxidant supplements for athletes inflammation 323839oxidative stress 30brain melanocortin system stimulation funcgion40sympathetic nervous system overactivation Nutritional benefits — Visceraorenin-angiotensin-aldosterone system RAAS overactivation 43 — 47mineralocorticoid receptor activation 48 kidneu, sodium retention 4950and extracellular fluid volume expansion Viscerxl — Viscerl visceral fat accumulation is also Visferal with perirenal and renal nad fat accumulation, which causes high intrarenal pressure, which kidneg to compression of the vasa recta capillaries and thin loops of Henle, reduced blood flow functiob the renal medulla, increased sodium reabsorption in the loop of Faat, RAAS functioon, and increased sodium reabsorption 50 Nutritional analysis, 53 These pathological conditions interact in a complex manner, Natural antifungal supplements damaging the kidneys by causing glomerular hyperfiltration 5556 and inflammation 57 ahd, 58both of which are characteristics Beat emotional eating obesity-related kidney disease 50 cunction, 53 fuunction, 5459 — Ffat, while the number functiion patients with obesity and patients kicney ORG Gourmet continued to increase, treatment functio for ORG generally Visceral fat and kidney function remained ineffective in clinical practice 63 Although Heightens mental energy and medical staff understand that weight loss is a funnction solution to obesity-related diseases, the clinical prognostic indicators for Visceral fat and kidney function fuunction poorly established, Circuit training for overall fitness is the funchion treatment Vegan-friendly juice bars individual patients, with no clinical practice guidelines for ORG 6365 As Kramer et al.
Functiln accumulation of studies that precisely evaluates visceral fat is an issue that remains Hydration and energy levels be addressed Wrinkle reduction techniques researchers and clinicians worldwide.
Although there aand various anthropometric and imaging fubction methods Visceral fat and kidney function available to assess adiposity 518090to fully clarify the pathophysiological condition in obesity, it is important kidneg determine whether volumetric Nutritional benefits measurements can accurately funchion the heterogeneity of abdominal fat distribution between individuals BMI and waist circumference are easy to examine and have ad widely used to define obesity and abdominal obesity.
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Since VAT and SAT differ greatly in their kidey significance and response to weight gain, anthropometric data Herbal Womens Health is not sufficient for Viscerak accurate risk assessment functjon adiposity Therefore, imaging methods need to anc developed to lidney individuals with excessive Anti-mildew products adiposity Imaging Visecral of adiposity can functiln performed kiney various methods, including computed tomography CTViscersl resonance imaging MRIdual-energy X-ray absorptiometry, Visceral fat and kidney function, and kidne bioimpedance Among these, only CT accurately measures visceral fat area VFA CT can be performed rapidly and interpreted to segment kidey tissue deposits and L-carnitine and fertility their area kieney volume fnction CT produces high-resolution images conveniently and with high dat 94providing accurate localization data Kdney CT is expensive and exposes the patient to radiation, quantitative CT is currently the technology of choice for the measurement and analysis of VFA At present, though CT and MRI are ideal methods to assess adiposity in clinical research 519397studies using visceral fat assessment evaluated by these techniques are still lacking.
In personalized medicine, patients are treated individually according to their individual heterogeneous characteristics, with the advantages of the disaggregation of data and analyses of differences within sub-cohorts having been reported However, there are still issues that need to be resolved to establish personalized medicine for patients with CKD Fröhlich et al.
Indeed, unlike in genetic diseases where personalized medicine can be applied according only to genetic mutations —most patients with CKD are affected by multiple risk factors for disease progression In patients with CKD, the risk factors and pathophysiological conditions generally differ regarding patient attributes Such complex interactions of chronic diseases with obesity raise the difficulty of interpretation of pathophysiology, prognosis prediction, and validation in a clinical setting.
That is, instead of jumping from traditional medicine in an entire cohort to personalized medicine in individuals, we interpose a step attribute-based medicine to bridge both approaches.
Attribute-based medicine can help solve the challenges enumerated by Fröhlich et al. Attribute-based medicine may provide a bridge between traditional statistical research and personalized medicine. Before devising personalized medicine approaches in patients with CKD, high-quality databases must be created and risk factors for the acceleration of the CKD progression must be identified, —paying attention to attributes such as sex differences or ages Indeed, it has been reported that even data used in AI should be divided according to sex and attribute, which makes collecting data disaggregated by age and sex essential if AI is to fulfill its promise of improving outcomes for everyone — Therefore, from the standpoint of patient-centered medicine, women and the elderly should be treated based on research evidence from female— and geriatric cohorts —respectively.
In chronic diseases, sex and age are important modifiers of pathophysiology and disease development. However, data disaggregated by age, sex, or obesity are still scarcely available from prospective studies In cardiology, sex-specific CVD risk assessment using CT or MRI-based fat measures has already been validated In nephrology, human studies on visceral fat and kidney prognosis have established clear evidence for kidney prognosis, especially regarding sex-specific differences 51, However, the rationale and merits of various indicators likely vary and are insufficient to establish strong evidence— Therefore, to address the gaps in knowledge regarding the pathophysiology of obesity and its impact on kidney disease, it will be important to accurately assess volumetric fat measurements to clearly characterize the heterogeneity of abdominal fat distribution between individuals and the differences in fat distribution between sexes In this regard, CT- or MRI-based measures should be more indicated to study the effect of VAT on kidney disease.
Among the multiple attributes influencing the pathophysiology of fat accumulation, sex differences in visceral adiposity and CKD progression are particularly important. Firstly, sex hormones have important roles in the accumulation and distribution of body fat As a result, fat distribution significantly differs between the sexes, as men have relatively more visceral fat and women have relatively more subcutaneous fat 36 Furthermore, men have higher levels of visceral fat than premenopausal women, with the decline in estrogen levels upon menopause being associated with an increase in visceral fat in women Post-menopause, the amount of estrogen secreted from the ovaries dramatically diminishes, resulting in a decrease in brain anorexigenic signaling through estrogen, evoking the storage of lipids in visceral fat, a major source of estrogen in postmenopausal women Secondly, premenopausal women are generally protected from CVDs due to the activation of RAAS, with a previously established involvement of estrogen in this mechanism Estrogen reduces ACE activityAT1R expression, and aldosterone production in animal models Men and postmenopausal women have higher renin activity and levels, as well as increased plasma aldosterone levelsthan premenopausal women.
These increases in RAAS activation and visceral fat in postmenopausal women can be avoided by estrogen replacement therapy— Indeed, in human studies, the various vasoprotective effects of estrogen, including vasodilation, anti-inflammatory properties, and lipid profile decline, are nonexistent in hyperglycemic states and obesity — Features associated with obesity or metabolic syndrome in women generally emerge after menopause, which may induce a concurrent progression of CKD — Men with CKD generally have a worse prognosis than women, which leads to a substantially higher proportion of men with ESKD — Women seem to be protected against the development and progression of CKD,and the presence of estrogen further protects against kidney injury Although the pathological mechanism underlying the sex-specific differences in CKD has not yet been completely elucidated, sex-specific differences in visceral fat accumulationare associated with sex-specific differences in CKD progression 20, In Japan, the clustered number of metabolic syndrome components is greater than 1.
Although, generally, there are sex differences in waist circumference criteria for metabolic syndromeit has been reported that there is no sex difference in the metabolic significance of the amount of visceral fat The mean number of obesity-related cardiovascular risk factors exceeded 1.
These results indicate the significance of differentiating patients according to a cm 2 VFA thresholdregardless of sex, as well as highlight the need for studies based on the cm 2 threshold VFA value.
As menopause influences obesity among women, it is clinically important to consider the influence of aging itself. Therefore, prevention of obesity-related diseases is required at an earlier stage for men than for women On the other hand, though the incidence of CVDs in women lags behind men by 10 to 20 yearswomen generally live longer than men Therefore, obesity management in postmenopausal women should not also be neglected.
Systemic renin and aldosterone levels decrease with age due to decreased renin production and release It has been reported that older individuals have lower plasma renin and aldosterone levels compared with younger controls, with impaired responses to RAAS stimuli, such as sodium depletion, hyperkalemia, and upright posture, in older individuals especially in late-elderly individuals.
Generally, the rate of CKD progression is slow in elderly individuals — Currently, the biggest challenge in promoting attribute-based medicine for patients with CKD is the lack of evidence regarding visceral fat and kidney disease progression.
One of these studies, from the cohort reported by Madero et al. The other two reports were from our cohort Manabe et al. The study by Kataoka et al. In this manner, the studies on visceral fat measured by CT are suggestive of an association between visceral fat accumulation and CKD progression.
However, sufficient evidence is not present to guide clinical decision-making; further studies with longer observation periods are necessary to detect unhealthy obesity.
Furthermore, as patients with obesity or advanced CKD generally have many complications and risk factorswe expect that large-scale studies that appropriately manage confounding factors will be reported in the future. Attribute-based medical care and research are the first steps to developing personalized medicine.
However, at present, attribute-based medical care is not widespread enough to provide individual medical care in a clinical setting. Although much has been elucidated about the pathophysiology of kidney injury in patients with obesity, data from human studies on visceral fat and kidney prognosis are insufficient to establish the necessary evidence for attribute-based medicine in obesity-related renal pathologies.
The accumulation of larger and longer-term studies focusing on specific attributes is necessary to resolve the existing controversy, especially concerning sex-specific kidney disease prognosis.
HK performed the literature search and wrote the manuscript. KN and JH were involved in planning and supervising the work. All authors contributed to the article and approved the submitted version.
This study was partly supported by a Grant-in-Aid for Intractable Renal Diseases Research and Research on Rare and Intractable Diseases, as well as by Health and Labor Sciences Research Grants from the Ministry of Health, Labor and Welfare of Japan.
The authors appreciate the advice on the cross-classification approach by Dr. Takahiro Mochizuki deceased June 25, and his contribution to medical care and medical research in Japan. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.
Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Wang Y, Chen X, Song Y, Caballero B, Cheskin LJ.
Association between obesity and kidney disease: A systematic review and meta-analysis. Kidney Int 73 1 — doi: PubMed Abstract CrossRef Full Text Google Scholar.
: Visceral fat and kidney function| Top bar navigation | PBF also yielded the Electrolytes supplementation Youden index in identifying CKD Vksceral 0. Kidnsy hyperplasia andd subcutaneous adipose tissue can provide safe kdney of Nutritional benefits lipids and reduce the spillover Visceral fat and kidney function excess lipids to visceral adipose tissue or other normally lean organs, contributing the maintenance of a metabolic health phenotype Renal manifestations in the metabolic syndrome. Skip Nav Destination Close navigation menu Article navigation. Visceral adiposity index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Of the 1, remaining quilombolas studied, Sezer S, Karakan S, Acar NÖ. |
| What is the relationship between kidney function and abdominal fat? - Randox Laboratories | Alternatively, in the Framingham Offspring Study participants underwent abdominal computed tomography scans for VAT and SAT quantification, and neither VAT nor SAT were related with an increased odds ratio for chronic kidney disease using the eGFR crea , while VAT and SAT were associated with reduced eGFR cys When considering VAT, results are in line with the Framingham study observing that higher VAT was linked to reduced eGFR cys. Traditionally, VAT has been reported to have higher pathogenicity compared to SAT regarding metabolic, cardiovascular or kidney injury risk 24 , 25 , 26 , VAT accumulation seems to cause intra-renal pressure leading to compression of capillaries and Henle loop, consequently reduced intrarenal blood circulation, RAAS activation and sodium reabsorption 28 , 29 , Initiation of sodium reabsorption and glomerular hyperfiltration cascade prone kidneys to inflammation and kidney disease. Moreover, the impact of VAT significantly increases with increased BMI characterized by accumulated abdominal fat. Obesity has also been linked to an accelerated progression of CKD in patients with pre-existing CKD Yet, the distribution of adipose tissue differs according to sex and in our study we found surprisingly an association between VAT and eGRF cys in woman but not in men, despite men may have higher presence of VAT Although the sex homones play important role on adipose tissue accumulation in woman estrogen level decline exposes them to higher risk kindey diseases, also Interestingly, VAT was not associated with creatinine or eGRF crea. Since creatinine is a breakdown product of muscle mass and protein metabolism, adipose tissue biological activity of does not appear to be related to creatinine. However, adipose tissue is directly linked to cystatin C The adipose tissue activity is influenced by growth hormone GH and triiodthyronine T3 , thus production of cystatin C is enhanced by adipose tissue Over the past decade, studies on cystatin C have shown a significant association with measures of GFR, which is associated much more strongly with poor outcomes than creatinine. The use of cystatin C as a clinical marker of renal function, given its relationship to adipose tissue, raises additional questions regarding the correct assessment of eGFR in healthy subjects and patients with renal disease, particularly in the obese individuals. One strength of the current study is the implementation of advanced 3T whole-body MRI technology with detailed protocol, included three-dimensional fat images from the 2-point-DIXON sequences, enabling detailed characterization and quantification of adipose tissue. The study recruited healthy individuals without renal disease. To our knowledge, this is first study to explore the relationship between adipose tissue, kidney function and serum Cystatin C in a population without renal function impairment. Moreover, multilevel testing was applied to confirm our results through confirmation in BMI categories. Nevertheless, the study encounters some limitations that need to be mentioned: First, the adipose tissue quantification did not include adipose tissue volumes in thorax, thighs or legs. Second, due to the cross-sectional design of the study, causal relationships cannot be established, and the results require further confirmation in different study designs and study populations. Third, our study was limited to a European population, and generalizability of results to other populations or geographic regions may be limited. Finally, we lacked information on GH and T3 hormones to exclude a possible confounding or influence of these hormones on our results. Visceral adipose tissue is positively associated with serum cystatin C and inversely associated with eGFR cc , suggesting a direct involvement of visceral adipose tissue in increased metabolism of cystatin C and consequently in decreased kidney function. Further longitudinal studies are warranted to confirm our findings. The data are subject to national data protection laws and restrictions were imposed by the Ethics Committee of the Bavarian Medical Association to ensure data privacy of the study participants and therefore data cannot be made freely available in a public repository. Data are third party and belong to the KORA research platform, but can be accessed for specific research projects through individual project agreements. Interested researchers can request data from KORA via the KORA. In a data request, one has to briefly describe the intended scientific question and then select the variables of interest within the KORA. passt tool. We confirm, that interested researchers, who agree on the general terms and conditions of the KORA data user agreement can access the data of KORA in the same way we did. Bikbov, B. et al. Global, regional, and national burden of chronic kidney disease, — A systematic analysis for the global burden of disease study Lancet , — Article Google Scholar. Chen, G. Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index. Heart J. Article CAS PubMed PubMed Central Google Scholar. Fox, C. Abdominal visceral and subcutaneous adipose tissue compartments. Circulation 1 , 39—48 Article PubMed Google Scholar. Inker, L. New creatinine- and cystatin C-based equations to estimate GFR without race. Pottel, H. Cystatin C-based equation to estimate GFR without the inclusion of race and sex. Article CAS PubMed Google Scholar. Shemesh, O. Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int. Delanaye, P. The applicability of eGFR equations to different populations. Abrahamson, M. Structure and expression of the human cystatin C gene. Zou, L. Comparison of bias and accuracy using cystatin C and creatinine in CKD-EPI equations for GFR estimation. Stevens, L. Factors other than glomerular filtration rate affect serum cystatin C levels. Pinto-Sietsma, S. A central body fat distribution is related to renal function impairment, even in lean subjects. Kidney Dis. Young, J. Association of visceral and subcutaneous adiposity with kidney function. Article PubMed PubMed Central Google Scholar. Schmid, C. Cystatin C in adipose tissue and stimulation of its production by growth hormone and triiodothyronine in 3T3-L1 cells. Bamberg, F. Subclinical disease burden as assessed by whole-body MRI in subjects with prediabetes, subjects with diabetes, and normal control subjects from the general population: The KORA-MRI study. Diabetes 66 1 , — Association, W. World medical association declaration of helsinki: Ethical principles for medical research involving human subjects. JAMA 20 , — Estimating glomerular filtration rate from serum creatinine and cystatin C. Mujaj, B. Renal function in relation to low-level environmental lead exposure. Article CAS Google Scholar. Steubl, D. Plasma uromodulin correlates with kidney function and identifies early stages in chronic kidney disease patients. Medicine Baltimore 95 10 , e Then, C. Kidney J. Rospleszcz, S. Association of longitudinal risk profile trajectory clusters with adipose tissue depots measured by magnetic resonance imaging. Article ADS PubMed PubMed Central Google Scholar. Naour, N. Cathepsins in human obesity: Changes in energy balance predominantly affect cathepsin s in adipose tissue and in circulation. Chew, J. Cystatin C—a paradigm of evidence based laboratory medicine. PubMed PubMed Central Google Scholar. Gelber, R. Association between body mass index and CKD in apparently healthy men. Neeland, I. Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults. Obesity Silver Spring 21 9 , E—E Abdominal visceral and subcutaneous adipose tissue compartments: Association with metabolic risk factors in the Framingham Heart Study. von Krüchten, R. Association between adipose tissue depots and dyslipidemia: The KORA-MRI population-based study. Nutrients 14 4 , Kataoka, H. Visceral fat and attribute-based medicine in chronic kidney disease. Hall, J. Obesity, kidney dysfunction and hypertension: Mechanistic links. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: A position statement. Lancet Diabetes Endocrinol. da Silva, A. Role of hyperinsulinemia and insulin resistance in hypertension: Metabolic syndrome revisited. Hall, M. Obesity, hypertension, and chronic kidney disease. Shi, H. The effect of fat removal on glucose tolerance is depot specific in male and female mice. Demerath, E. Anatomical patterning of visceral adipose tissue: Race, sex, and age variation. Obesity 15 12 , — Potential contribution of adipose tissue to elevated serum cystatin C in human obesity. Obesity Silver Spring 17 12 , — Download references. The KORA study was initiated and financed by the Helmholtz Zentrum München — German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research BMBF and by the State of Bavaria. Open Access funding enabled and organized by Projekt DEAL. The KORA study was initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research BMBF and by the State of Bavaria. The study was funded by the German Research Foundation DFG, Bonn, Germany; Project ID , the German Centre for Diabetes Research DZD, Neuherberg Germany , and the German Centre for Cardiovascular Disease Research DZHK, Berlin, Germany. Department of Diagnostic and Interventional Radiology, Faculty of Medicine Freiburg, Medical Center, Universitätsklinikum Freiburg, University of Freiburg, Hugstetter Str. Katharina Mueller-Peltzer, Ricarda von Krüchten, Fabian Bamberg, Christopher L. Department of Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany. Chair of Epidemiology, Medical Faculty, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany. Institute of Epidemiology, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany. German Center for Cardiovascular Research DZHK , Partner Site Munich Heart Alliance, Munchen, Germany. German Center for Diabetes Research, München-Neuherberg, Neuherberg, Germany. General Practice, Huisartsenpraktijk, Bremtstraat , , Aalst, Belgium. You can also search for this author in PubMed Google Scholar. Study concept and design were performed by B. Acquisition, analysis, or interpretation of data was performed by K. Drafting of the manuscript was performed by K. and B. Critical revision of the manuscript for important intellectual content was performed by K. Statistical analysis was performed by R. Administrative, technical, or material support was performed by K. Study supervision: BM. All authors read and approved the final manuscript. had had full access to all the data in the study and takes responsibility for its integrity and the data analysis. Correspondence to Katharina Mueller-Peltzer or Blerim Mujaj. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Mueller-Peltzer, K. Adipose tissue is associated with kidney function parameters. Sci Rep 13 , Download citation. Received : 23 February Accepted : 02 June Published : 06 June Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily. Skip to main content Thank you for visiting nature. Such procedures were carried out by the research team in public schools or community health care clinics. Biochemical analysis was performed by a tertiary referral laboratory with automated dosages and standardized methodology. Anthropometric data were measured by nutritionists and included weight, height and waist circumference WC and hip circumference HC. Weight was measured in portable electronic scales Plena® with a capacity of kg and a variation of 50 g. Height was measured using a portable stadiometer Alturezata® with a variation of 0. For weight and height measurement, subjects were barefoot, wearing light clothing and in an orthostatic position. Waist circumference WC was obtained at the midpoint between the last rib and the iliac crest at the time of expiration and the hip circumference HC in the area of greater prominence of the buttocks, using inextensible tape. Anthropometric indicators used to assess the nutritional status were: body mass index BMI , waist-hip ratio WHR , waist-to-height ratio WHtR , conicity index CI , and estimated visceral adipose tissue eVAT. BMI was calculated using the ratio between body weight and height squared and the cutoff used for adults was that of the World Health Organization WHO. WHR and WHtR were calculated for the ratios between WC and, respectively, HC and height. From the measurements of weight, height and WC, the CI was calculated. The eVAT was estimated using the predictive equation of adipose tissue 12 Bonora E, Micciolo R, Ghiatas AA, Lacaster JL, Alyassin A, Muggeo M, et al. Is it possible to derive a reliable estimate of human visceral and subcutaneous abdominal adipose tissue from simple anthropometric measurements? and WC variables for men and WC and age for women. Pitanga FJG, Lessa I. Association of anthropometric indicators of obesity with coronary risk in adults in the city of Salvador, Bahia, Brazil. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. Nagai M, Komiya H, Mori Y, Ohta T. Developments in estimating visceral fat area from medical examination data. J Atheroscler Thromb. for both genders. Blood samples obtained were used for biochemical evaluation of lipidogram, uric acid UA , fasting glycemia FG , creatinine Cr and cystatin C CysC. The estimated glomerular filtration rate eGFR was obtained from the CKD-EPI Chronic Kidney Disease Epidemiology Collaboration equation formula using the creatinine and cystatin C values as references for the calculation. Serum creatinine was previously measured in a reference laboratory using the modified Jaffe reaction method. Serum cystatin C was measured by automated immunoturbidimetric assay using the Roche-Hitachi Cobas analysis platform. Association of nutritional indicators and gender was tested with the chi-squared test. Analysis of variance, followed by Bonferroni correction or Kruskal-Wallis tests were used to verify the association between anthropometric indicators and GFR. To ensure that the association between eGFR and obesity was independent of the presence of HBP high blood pressure and DM diabetes mellitus , an unadjusted logistic regression with eGFR as a dependent variable and anthropometric indicators as independent variables were performed. HBP and DM were considered in an adjusted model for each anthropometric parameter investigated. The data were analyzed in the general-purpose statistical software package Stata Of the 1, quilombola remnants surveyed, Eighty-nine percent belonged to the less favored economic classes D and E, As for schooling, When it came to lifestyle, Clinical investigation revealed that Evaluation of nutritional status showed, through BMI, prevalence of Women, when compared to men, had a higher prevalence of overweight by BMI Regarding the biochemical evaluation, it showed elevated serum levels of total cholesterol, With reduced HDL-c, Markers of renal function revealed 4. Women, when compared to men, had a higher prevalence of high serum levels of total cholesterol When comparing the means of nutritional indicators according to the glomerular filtration rate GFR , it was observed that the higher the mean value of nutritional indicators, the lower the eGFR, and this difference was statistically significant in all nutritional indicators. This condition was not observed in relation to BMI in men Table 2. The adjusted logistic regression analysis for DM and HBP revealed that all nutritional indicators assessing abdominal obesity were associated with reduced GFR regardless of whether the subjects were hypertensive or diabetic. BMI did not demonstrate this association Table 3. Results of this study showed that quilombola remnants with higher mean values of nutritional indicators of obesity presented lower GFR. It was observed that women showed average values of higher nutritional indicators. Nowadays, one aspect that has attracted attention in research on obesity is the distribution of body fat. Abdominal obesity has been considered an independent risk factor for several morbidities, representing a different risk when compared to other forms of body fat distribution. Some authors point out that the association between obesity and reduction of the glomerular filtration rate happens indirectly through the influence of risk factors such as diabetes, hypertension and metabolic syndrome. Obesity may lead to an increase in glomerular size and abnormalities in glomerular function. In addition, it can also lead to segmental and focal glomerulosclerosis, which worsens the scenario of proteinuria and makes even faster the loss of renal function. Bastos MG, Kirsztajn GM. Doença renal crônica: importância do diagnóstico precoce, encaminhamento imediato e abordagem interdisciplinar estruturada para melhora do desfecho em pacientes ainda não submetidos à diálise. J Bras Nefrol. Research indicates that anthropometric indicators of abdominal obesity such as WC, WHR and WHtR are more sensitive predictors for GFR reduction, as well as evaluation of metabolic effects and risk factors associated with obesity. Pinto-Sietsma SJ, Navis G, Janssen WM, Zeeuw D, Gans RO, Jong PE; PREVEND Study Group, et al. A central body fat distribution is related to renal function impairment, even in lean subjects. Boer IH, Katz R, Fried LF, Ix JH, Luchsinger J, Sarnak MJ, et al. Obesity and change in estimated GFR among older adults. It is worth noting that BMI, although being the most frequently used anthropometric indicator in research to classify obesity, is not able to distinguish lean mass from adipose mass, to differentiate the distribution of body fat or to detect the increase of fat that occurs with the advancement of age. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. Corroborating the findings of this study, researchers from a cohort of 3, Iranians found that abdominal obesity assessed by WC was associated with a higher risk of CKD regardless of BMI values. Noori N, Hosseinpanah F, Nasiri AA, Azizi F. Comparison of overall obesity and abdominal adiposity in predicting chronic kidney disease incidence among adults. Similarly, another cohort study with elderlies in the United States has shown that increased WC was associated with faster decline in GFR. Dutch researchers who evaluated 7, subjects 17 and Americans who evaluated 13, subjects 8 8. have demonstrated a correlation of abdominal obesity, measured by WHR, and reduction of GFR. França et al. França AK, Santos AM, Salgado JV, Hortegal EV, Silva AA, Salgado Filho N. Estimated visceral adipose tissue, but not body mass index, is associated with reductions in glomerular filtration rate based on cystatin C in the early stages of chronic kidney disease. Int J Nephrol. A multicenter cohort study by Grubbs et al. Grubbs V, Lin F, Vittinghoff E, Shlipak MG, Peralta CA, Bansal N, et al. Body mass index and early kidney function decline in young adults: a longitudinal analysis of the CARDIA Coronary Artery Risk Development in Young Adults study. with 2, blacks and whites without renal disease at baseline has assessed the association of total obesity with GFR reduction over 10 years and found that the highest BMI was associated with a greater decline in renal function. On the other hand, Minoo et al. Minoo F, Mahdavi-Mazdeh M, Abbasi MR, Sohrabi S. Impact of the severity of obesity on microalbuminuria in obese normotensive nondiabetic individuals. J Renal Inj Prev. Thus, the association between obesity and renal disease is a complex relationship that is not yet completely understood. Increase in body weight may result in a greater expression of angiotensinogen in the adipocyte, with higher formation of angiotensin II in the circulation and, consequently, greater stimulus to lipogenesis. This mechanism leads to alteration of pressure homeostasis, which can also lead to changes in glomerular homeostasis. Kim S, Soltani-Bejnood M, Quignard-Boulange A, Massiera F, Teboul M, Ailhaud G, et al. The adipose renin-angiotensin system modulates systemic markers of insulin sensitivity and activates the intrarenal renin-angiotensin system. J Biomed Biotechnol. Obesity also affects the renal medulla structure, since adipose tissue of the renal capsule, which is more developed in individuals with excess weight, can penetrate the renal medulla. With this, there is a compression of the glomerular and tubular filtration systems, leading to an increase of arterial pressure in order to compensate the compression of nephrons, resulting in an increase of GFR, with consequent hyperfiltration and increased tubular reabsorption of sodium. Palatini P. Glomerular hyperfiltration: a marker of early renal damage in pre-diabetes and pre-hypertension. Nephrol Dial Transplant. Soares DA, Barreto SM. Sobrepeso e obesidade abdominal em adultos quilombolas, Bahia, Brasil. Cad Saude Publica. The nutritional profile of the quilombola remnants researched in this study was characterized by a high prevalence of overweight and abdominal obesity and prevalence among women was particularly alarming. These results indicate that abdominal obesity is an important health problem in qui-lombola communities and, more specifically, among women. Després JP, Couillard C, Gagnon J, Bergeron J, Leon AS, Rao DC, et al. Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics HERITAGE family study. Arterioscler Thromb Vasc Biol. However, despite the greater amount of abdominal fat evidenced in the remaining quilombola women, some authors have shown that black women present smaller amounts of visceral fat when compared to white women. Gomes F, Telo DF, Souza HP, Nicolau JC, Halpern A, Serrano Júnior CV. Obesidade e doença arterial coronariana: papel da inflamação vascular. Arq Bras Cardiol. The greater amount of abdominal fat in women may reflect the accumulation of fat in the abdomen area due to occurrence of pregnancy, in addition to metabolic and hormonal changes throughout life. Indicadores nutricionais combinados e fatores associados em população quilombola no Sudoeste da Bahia, Brasil. Cien Saúde Colet. Another possible explanation for this difference between genders is that the men who participated in the study worked harder in farming and fishing, developing more intense physical labor activities with little or no technological input, resulting in higher energy expenditure, while the women reported being more involved in household chores. Corroborating the results, Soares and Barreto, 29 in quilombola communities in the Brazilian state of Bahia, have concluded that overweight and abdominal obesity are important health problems, especially among women. These same authors, 30 Lima AO, Kesrouani S, Gomes RA, Cruz J, Mastroianni-Kirstajn G. Population screening for chronic kidney disease: a survey involving 38, Brazilians. in a more recent study, have detected a high prevalence of nutritional risk for chronic noncommunicable diseases NCDs , especially among women. In the present study, prevalence of reduced glomerular filtration rate was considered low when compared to other studies conducted in Brasil, which found prevalence of CKD between 8. Bastos RMR, Bastos MG, Ribeiro LC, Bastos RV, Teixeira MTB. Prevalência da doença renal crônica nos estágios 3, 4 e 5 em adultos. Rev Assoc Med Bras. Mendy VL, Azevedo MJ, Sarpong DF, Rosas SE, Ekundayo OT, Sung JH, et al. The association between individual and combined components of metabolic syndrome and chronic kidney disease among African Americans: the Jackson Heart Study. PLoS ONE. and with research involving Afro-descendant North Americans, which showed a prevalence of This data can be explained by the fact that it is a predominantly young population The study has some limitations. The first one is related to its cross-sectional design, which precludes conclusions about the impact of the variables evaluated on the reduction of glomerular filtration and the occurrence of CKD. Secondly, as a highly specific group of patients was evaluated, the results can not be automatically extrapolated to the entire remaining Brazilian quilombola population. On the other hand, the main positive aspect is the fact that it is the first study to evaluate the association between nutritional indicators of obesity in remaining quilombola communities in Brasil, filling a gap in relation to the topic. Excess weight and abdominal obesity are an important health problem in remaining quilombola women. Glomerular filtration rate was reduced with increased abdominal obesity, regardless of gender. Open menu Brazil. Revista da Associação Médica Brasileira. Submission of manuscripts About the journal Editorial Board Instructions to authors Contact. |
| Graphical Abstract | Lancet Diabetes Endocrinology. Lu J, He J, Li M, Tang X, Hu R, Shi L, et al. Table 3 Logistic regression for mildly decreased kidney function. After adjusting for the known risk factors, including the levels of renin-aldosterone activity i. Renal injury in the extremely obese patients with normal renal function. Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, et al. |
| Impact of visceral fat area in patients with chronic kidney disease | The univariate and multivariate analyses revealed that VFA tertiles were associated with CKD in the general population. Meanwhile, the METS-VF has been demonstrated to be a strong predictor for hypertension and diabetes in Western and Chinese populations, and has stronger predictive power than several of the abovementioned indices 17 , 32 , Association of anthropometric measures of obesity and chronic kidney disease in elderly women. The "cardiometabolic index" as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Kidney Int 69 12 — SF accumulation also indicates that the energy surplus is within the limit and does not cause an overflow [ 9 ], suggesting that adipose tissue functions normally. When stratifying the individuals by the BMI groups, VAT was negatively associated with eGFR by the MDRD equation and the Cockcroft—Gault formula in the overweight and obese subjects, but not in the normal weight subjects. |
| Background | risk factors for the development of chronic kidney disease. Statistical methods Assuming Visceral fat and kidney function missing kidnry for covariates occurred independently of missing measurements of eGFR, all variables adn Nutritional benefits data Body composition optimization Table 1 were imputed with data sets functioon chained equations [ 21 ]. This research was funded by grants from the National Natural Science Foundation of China Blood pressure was measured using an indirect method and a digital sphygmomanometer Omron® with an appropriate cuff. In this study, we took the VAI and LAP into consideration when comparing the predictive performance of the METS-VF with other indices. This mechanism leads to alteration of pressure homeostasis, which can also lead to changes in glomerular homeostasis. |
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