Diabetes research and clinical practice · 2025
Peri-renal and renal sinus fat accumulation and diabetic kidney disease in type 2 diabetes: A Japanese cohort study.
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Tanabe Hayato, Kono Teruyuki, Saito Haruka, Maimaituxun Gulinu, Tanaka Kenichi, Kazama Junichiro J, Shimabukuro Michio
Аннотация
AIMS: This 15-year cohort study assessed whether peri-renal fat volume index (PRFVI) and renal sinus fat volume index (RSFVI) predict diabetic kidney disease (DKD) better than general or abdominal obesity measures in Japanese adults with type 2 diabetes (T2D).
METHODS: Researchers studied 190 DKD-free individuals, measured their abdominal and renal fat via computed tomography, and categorized them into tertiles based on five adiposity indices: body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), PRFVI, and RSFVI.
RESULTS: Participants averaged 58 years old; 52.6 % were male with a median diabetes duration of 5 years and a BMI of 25.4 kg/m2. PRFVI correlated with BMI, whereas RSFVI correlated with aging. Over a median 8.5-year follow-up, 53.7 % of patients developed DKD. Notably, higher RSFVI tertiles were significantly associated with DKD risk (hazard ratio 1.96, 95 % confidence interval 1.14-3.39, P = 0.016), and RSFVI had the best predictive value for DKD among all indices (AUC = 0.769). Both renal fat indices showed stronger associations with DKD development than traditional obesity measures.
CONCLUSIONS: The findings demonstrate that renal fat measure, particularly RSFVI, provides incremental predictive value independent of conventional DKD risk variables, suggesting that local renal fat may be a target for early DKD detection and intervention in people with T2D.
METHODS: Researchers studied 190 DKD-free individuals, measured their abdominal and renal fat via computed tomography, and categorized them into tertiles based on five adiposity indices: body mass index (BMI), visceral fat area (VFA), subcutaneous fat area (SFA), PRFVI, and RSFVI.
RESULTS: Participants averaged 58 years old; 52.6 % were male with a median diabetes duration of 5 years and a BMI of 25.4 kg/m2. PRFVI correlated with BMI, whereas RSFVI correlated with aging. Over a median 8.5-year follow-up, 53.7 % of patients developed DKD. Notably, higher RSFVI tertiles were significantly associated with DKD risk (hazard ratio 1.96, 95 % confidence interval 1.14-3.39, P = 0.016), and RSFVI had the best predictive value for DKD among all indices (AUC = 0.769). Both renal fat indices showed stronger associations with DKD development than traditional obesity measures.
CONCLUSIONS: The findings demonstrate that renal fat measure, particularly RSFVI, provides incremental predictive value independent of conventional DKD risk variables, suggesting that local renal fat may be a target for early DKD detection and intervention in people with T2D.