肾周脂肪在伴有或不伴有糖尿病的慢性肾功能衰竭患者肾功能障碍中的作用:一项日本横断面研究

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM BMJ Open Diabetes Research & Care Pub Date : 2024-03-01 DOI:10.1136/bmjdrc-2023-003832
Teruyuki Kono, Gulinu Maimaituxun, Hayato Tanabe, Moritake Higa, Haruka Saito, Kenichi Tanaka, Hiroaki Masuzaki, Masataka Sata, Junichiro J. Kazama, Michio Shimabukuro
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Multivariate-adjusted models were used to determine the ORs of PRFV and PRFV index for detecting estimated GFR (eGFR) decrease of <60 mL/min/1.73 m2 proteinuria onset, or both. Results Although body mass index (BMI), visceral fat area, and waist circumference were comparable between the non-DM and DM groups, kidney volume, PRFV, and PRFV index were higher in individuals with T2DM than in those without T2DM. In the multivariate analysis, after adjusting for age, sex, BMI, hypertension, smoking history, and visceral fat area ≥100 cm2, the cut-off values of PRFV index were associated with an eGFR<60 in individuals with DM (OR 6.01, 95% CI 2.20 to 16.4, p<0.001) but not in those without DM. Conclusions PRFV is associated with low eGFR in patients with T2DM but not in those without T2DM. This suggests that PRF accumulation is more closely related to the onset and progression of diabetic kidney disease (DKD) than non-DKD. Clarifying the mechanisms through which PRF influences DKD development could pave the way for novel prevention and treatment strategies. Data are available upon reasonable request. All datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.","PeriodicalId":9151,"journal":{"name":"BMJ Open Diabetes Research & Care","volume":"1 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Role of perirenal adiposity in renal dysfunction among CKD individuals with or without diabetes: a Japanese cross-sectional study\",\"authors\":\"Teruyuki Kono, Gulinu Maimaituxun, Hayato Tanabe, Moritake Higa, Haruka Saito, Kenichi Tanaka, Hiroaki Masuzaki, Masataka Sata, Junichiro J. Kazama, Michio Shimabukuro\",\"doi\":\"10.1136/bmjdrc-2023-003832\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction It remains unclear whether increased perirenal fat (PRF) accumulation is equally related to renal involvement in patients with and without diabetes mellitus (DM). We evaluated the association between PRF volume (PRFV) and low glomerular filtration rate (GFR) and proteinuria in people with or without type 2 diabetes mellitus (T2DM). Research design and methods We performed a cross-sectional analysis of 473 individuals without T2DM (non-DM, n=202) and with T2DM (DM, n=271). PRFV (cm3), obtained from non-contrast CT, was indexed as PRF index (PRFV/body surface area, cm3/m2). Multivariate-adjusted models were used to determine the ORs of PRFV and PRFV index for detecting estimated GFR (eGFR) decrease of <60 mL/min/1.73 m2 proteinuria onset, or both. Results Although body mass index (BMI), visceral fat area, and waist circumference were comparable between the non-DM and DM groups, kidney volume, PRFV, and PRFV index were higher in individuals with T2DM than in those without T2DM. In the multivariate analysis, after adjusting for age, sex, BMI, hypertension, smoking history, and visceral fat area ≥100 cm2, the cut-off values of PRFV index were associated with an eGFR<60 in individuals with DM (OR 6.01, 95% CI 2.20 to 16.4, p<0.001) but not in those without DM. Conclusions PRFV is associated with low eGFR in patients with T2DM but not in those without T2DM. This suggests that PRF accumulation is more closely related to the onset and progression of diabetic kidney disease (DKD) than non-DKD. Clarifying the mechanisms through which PRF influences DKD development could pave the way for novel prevention and treatment strategies. Data are available upon reasonable request. 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引用次数: 0

摘要

导言:对于糖尿病(DM)患者和非糖尿病(DM)患者,肾周脂肪(PRF)堆积的增加是否同样与肾脏受累有关,目前仍不清楚。我们评估了 2 型糖尿病(T2DM)患者或非 2 型糖尿病(T2DM)患者肾周脂肪量(PRFV)与低肾小球滤过率(GFR)和蛋白尿之间的关系。研究设计和方法 我们对 473 名无 T2DM(非 T2DM,n=202)和有 T2DM(DM,n=271)的人进行了横断面分析。从非对比 CT 中获得的 PRFV(立方厘米)被指数化为 PRF 指数(PRFV/体表面积,立方厘米/平方米)。使用多变量调整模型确定 PRFV 和 PRFV 指数检测估计 GFR(eGFR)下降<60 mL/min/1.73 m2 蛋白尿发病或两者的 OR。结果 虽然非糖尿病组和糖尿病组的体重指数(BMI)、内脏脂肪面积和腰围相当,但 T2DM 患者的肾脏体积、PRFV 和 PRFV 指数均高于非 T2DM 患者。在多变量分析中,在调整了年龄、性别、体重指数、高血压、吸烟史和内脏脂肪面积≥100 cm2 后,PRFV 指数的临界值与 DM 患者的 eGFR<60 相关(OR 6.01,95% CI 2.20 至 16.4,p<0.001),但与非 DM 患者无关。结论 PRFV 与 T2DM 患者的低 eGFR 相关,但与非 T2DM 患者无关。这表明,与非糖尿病肾病相比,PRF 的积累与糖尿病肾病(DKD)的发生和发展关系更为密切。阐明 PRF 影响 DKD 发展的机制可为新型预防和治疗策略铺平道路。如有合理要求,可提供相关数据。本研究中生成和/或分析的所有数据集均未公开,但可向通讯作者索取。
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Role of perirenal adiposity in renal dysfunction among CKD individuals with or without diabetes: a Japanese cross-sectional study
Introduction It remains unclear whether increased perirenal fat (PRF) accumulation is equally related to renal involvement in patients with and without diabetes mellitus (DM). We evaluated the association between PRF volume (PRFV) and low glomerular filtration rate (GFR) and proteinuria in people with or without type 2 diabetes mellitus (T2DM). Research design and methods We performed a cross-sectional analysis of 473 individuals without T2DM (non-DM, n=202) and with T2DM (DM, n=271). PRFV (cm3), obtained from non-contrast CT, was indexed as PRF index (PRFV/body surface area, cm3/m2). Multivariate-adjusted models were used to determine the ORs of PRFV and PRFV index for detecting estimated GFR (eGFR) decrease of <60 mL/min/1.73 m2 proteinuria onset, or both. Results Although body mass index (BMI), visceral fat area, and waist circumference were comparable between the non-DM and DM groups, kidney volume, PRFV, and PRFV index were higher in individuals with T2DM than in those without T2DM. In the multivariate analysis, after adjusting for age, sex, BMI, hypertension, smoking history, and visceral fat area ≥100 cm2, the cut-off values of PRFV index were associated with an eGFR<60 in individuals with DM (OR 6.01, 95% CI 2.20 to 16.4, p<0.001) but not in those without DM. Conclusions PRFV is associated with low eGFR in patients with T2DM but not in those without T2DM. This suggests that PRF accumulation is more closely related to the onset and progression of diabetic kidney disease (DKD) than non-DKD. Clarifying the mechanisms through which PRF influences DKD development could pave the way for novel prevention and treatment strategies. Data are available upon reasonable request. All datasets generated and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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