SP319RELATIONSHIP OF VISCERAL AND SUBCUTANEOUS FAT WITH THE DECREASE OF RENAL FUNCTION FOR SEVEN YEARS IN PEOPLE WITH OBESITY

Abstract

Introduction and Aims: Obesity is increasing worldwide and previous studies have demonstrated that obesity is a risk factor for chronic kidney disease and end-stage renal disease. Visceral fat area (VFA) and subcutaneous fat area (SFA) may have differential metabolic risks. It has been reported that VAT measured by computed tomography (CT) is more strongly associated with an adverse metabolic risk, as compared to that of SAT. The aim of this study is to determine whether VFA or SFA was associated with the decrease of renal function for seven years in people with obesity. Methods: 65 obese subjects with company medical checkups in Japan, who had undergone abdominal CT at the time and with a history of medical checkups seven years ago, were enrolled in this retrospective study. Obesity was defined as a body mass index(BMI) of 25 kg/m2 or above. Renal function was evaluated based on the estimated glomerular filtration rate, which was calculated from the plasma creatinine values. ΔeGFR was defined as a decrease of eGFR for seven years. The distribution of body fat was determined using CT imaging. We analyzed relationship between fat area(VFA or SFA) and ΔeGFR or factors affecting renal function, such as age, BMI, blood pressure value, hemoglobin(Hb) levels, albumin levels, low-density lipoprotein-cholesterol (LDL-C) levels, high-density lipoprotein-cholesterol (HDL-C) levels, triglyceride (TG) levels, fasting blood glucose levels and C-reactive protein (CRP) levels. Results: The mean age of the 65 subjects was 44.3 ± 8.7 years (range, 29-67); 36 (55.3%) of the subjects were male. All patients were followed for seven years. The mean eGFR was 77.5 ± 11.7 ml/min/1.73m2 (range, 55-104) and the mean reduction of eGFR for 7 years (ΔeGFR) was 2.1 ± 8.5 ml/min/1.73m2. The mean BMI and waist circumference were 26.3 ± 7.6 kg/m2 and 81.6 ± 9.8 cm. The mean VFA and SFA were 90.7 ± 30.8 and 239.9 ± 71.6 cm2 (Table 1). BMI was significantly associated with both VFA and SFA. The correlation of BMI with VFA and SFA was 0.478 and 0.810, respectively (P<0.001). On the univariate analysis, the VFA was significant correlated with age (r=0.287, P=0.021), BMI (r=0.478, P<0.001),ΔeGFR (r=0.260, P=0.036), Hb levels, serum LDL-C levels (r=0.275, P=0.027) or serum HDL-C levels (r=-0.046, P<0.001). On the multivariate analysis, age (β value=0.386, P<0.001) and ΔeGFR (β value=0.192, P=0.042) were significant independent determinants of the VFA. On the other hand, on the univariate analysis, the SFA was significant correlated with BMI (r=0.478, P<0.001) but not withΔeGFR and lipid parameters. On the multivariate analysis, BMI (β value=0.386, P<0.001) were significant independent determinants of the SFA. Conclusions: In the present study, ΔeGFR for seven years was significantly associated with the VFA, not the SFA in obese subjects with company medical checkups.