Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index. (June 2015) - Lee, Jeognhwan
Abstract : Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography(CT) in healthy Korean adults. The study population included individuals aged 20–64 years who went a routine health check-up including an abdominal CT scan. We selected 4, 378 individuals without diabetes, hypertension, overt proteinuria, or hematuria. Creatinine clearance was estimated using the Cockcroft-Gault equation, and glomerular hyperfiltration was defined as the highest quintile of creatinine clearance. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous and visceral adipose tissue areas (SAT: men, OR = 14.06 (9.02–21.92), women, OR = 9.37 (5.81–15.12); VAT: men, OR = 6.30 (4.25–9.35), women, OR = 8.91 (5.24–15.15) for the comparisons of lowest vs. highest quartile; all P for trend <0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m 2, overweight ≥ 23 kg/m 2 ), subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (men, OR = 6.44 (1.79–23.21), P for trend =0.006; women, OR = 4.10 (2.28–7.38), P for trend <0.001 for the comparisons of lowest vs. highest quartile). The visceral adipose tissue area was also associated with glomerular hyperfiltration both in men and women with normal BMIs (men, OR = 5.09 (1.76–14.68); women, OR = 4.58 (2.36–8.88)). Among women, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased after menopause. Subcutaneous and visceral adipose tissueareas are positively associated with glomerular hyperfiltration in healthy Korean adults without diabetes or hypertension. Even in the normal BMI group, subjects with greater subcutaneous and visceral adipose tissue had a higher prevalence of glomerular hyperfiltration.