Exp Clin Endocrinol Diabetes 2008; 116(2): 99-103
DOI: 10.1055/s-2007-992117
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

The Relationship between Body fat Distribution and Renal Damage in Chinese with Obesity

H. Chen 1 , Z. Liu 1 , S. Li 1 , Y. Chen 1 , B. Yang 1 , J. Cai 1 , Q. Wang 1 , L. Li 1
  • 1Research Institute of Nephrology, Jinling Hospital, Medical School, Nanjing University, Nanjing, P. R. China
Further Information

Publication History

received 07.04.2007 first decision 14.06.2007

accepted 02.10.2007

Publication Date:
20 December 2007 (online)

Abstract

Objective: It has been recognized that in addition to being overweight, abnormal fat distribution may be associated with the etiology of metabolic syndrome. Asian people are more prone to develop visceral obesity than people in western countries. The present study was initiated to evaluate the relationship between visceral obesity and renal damage in Chinese obese people.

Methods: As measured by computed tomography, the areas of visceral fat were compared between 30 patients with biopsy-proven obesity-related glomerulopathy (ORG) and 20 obese volunteer controls that were free of renal diseases. The two groups were matched for age and sex.

Results: It was found that the areas of visceral fat were markedly increased in patients with ORG, while body mass indexes were similar in the two groups. Patients with ORG also showed higher levels of total cholesterol and a higher degree of insulin resistance than the controls. Multiple logistic regression analysis revealed that visceral obesity was significantly associated with the prevalence of ORG (OR 1.136; 95%CI, 1.106-1.166; P=0.003). Interestingly, proteinuria level was related directly with waist circumference, visceral obesity and levels of total cholesterol, fasting glucose, insulin and HOMA-IR (P<0.05). Moreover, only HOMA-IR was independently associated with proteinuria level in stepwise linear regression (r=0.641; P=0.001).

Conclusions: The present study illustrated the positive association between visceral obesity and ORG and between insulin resistance and proteinuria level in Chinese obese subjects.

References

  • 1 Weisinger JR, Kempson RL, Eldridge FL. et al . The nephritic syndrome: a complication of massive obesity.  Ann Intern Med. 1974;  81 440-447
  • 2 Sedjo BT. et al . Public health response to the obesity epidemic: too soon or too late?.  J Nutr. 2007;  137 488-492
  • 3 Gelber RP, Kurth T, Kausz AT. et al . Association between body mass index and CKD in apparently healthy men.  Am J Kidney Dis. 2005;  46 871-880
  • 4 Bosma RJ, Heide JJH van der, Oosterop EJ. et al . Body mass index is associated with altered renal hemodynamics in non-obese healthy subjects.  Kidney Int. 2004;  65 259-265
  • 5 Bonnet F, Marre M, Halimi JM. et al . Waist circumference and the metabolic syndrome predict the development of elevated albuminuria in non-diabetic subjects: the DESIR Study.  J Hypertension. 2006;  24 1157-1163
  • 6 Pinto-Sietsma SJ, Navis G, Janssen WM. et al . A central body fat distribution is related to renal function impairment, even in lean subjects.  Am J Kidney Dis. 2003;  41 733-741
  • 7 Sarafidis PA, Ruilope LM. Insulin resistance, hyperinsulinemia, and renal injury: mechanisms and implications.  Am J Nephrol. 2006;  26 232-244
  • 8 Gu DF, Reynolds K, Wu X. et al . Prevalence of the metabolic syndrome and overweight among adults in China.  Lancet. 2005;  365 1398-1405
  • 9 MacKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians.  Lancet. 1991;  337 382-386
  • 10 Li G, Chen X, Jang Y. et al . Obesity, coronary heart disease risk factors and diabetes in Chinese: an approach to the criteria of obesity in the Chinese population.  Obes Rev. 2002;  3 167-172
  • 11 The World Health Organization Western Pacific Region, the International Association for the Study of Obesity, and the International Obesity Task Force .The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne: Health Communications Australia 2000
  • 12 Jafar TH, Stark PC, Schmid CH. et al . Proteinuria as a modifiable risk factor for the progression of non-diabetic renal disease.  Kidney Int. 2001;  60 1131-1140
  • 13 Ribeiro-Filho FF, Faria AN, Azjen S. et al . Methods of estimation of visceral fat: advantages of ultrasonography.  Obesity research. 2003;  11 1488-1494
  • 14 Chen H, Liu Z, Zeng C. et al . Podocyte lesions in patietns with obesity-related glomerulopathy.  Am J Kidney Dis. 2006;  48 772-779
  • 15 Rossner S, Bo WJ, Hiltbrandt E. et al . Adipose tissue determinations in cadavers - a comparison between cross-sectional planimetry and computed tomography.  Int J Obes Relat Metab Disord. 1990;  14 893-902
  • 16 Rockall AG, Sohaib SA, Evans D. et al . Computed tomography assessment of fat distribution in male and female patients with Cushing's syndrome.  Eur J Endocrinol. 2003;  149 561-567
  • 17 Kobayashi J, Sasaki T, Mitsuyo W. The relationship of abdominal fat mass assessed by helical or conventional computed tomography to serum leptin concentration.  J Atheroscler Thromb. 2004;  11 173-179
  • 18 Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling.  Diabetes Care. 2004;  27 1487-1495
  • 19 Chang Y, Yoo T, Ryu S. et al . Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men.  Int J Obes. 2006;  30 800-804
  • 20 Boer IH de, Sibley SD, Kestenbaum B. et al . Central obesity, incident microalbuminuria, and change in creatinine clearance in the epidemiology of diabetes interventions and complications study.  J Am Soc Nephrol. 2007;  18 235-243
  • 21 Chen J, Muntner P, Hamm LL. et al . Insulin resistance and risk of chronic kidney disease in non-diabetic US adults.  J Am Soc Nephrol. 2003;  14 469-477
  • 22 Parvanova AI, Trevisan R, Iliev IP. et al . Insulin resistance and microalbuminuria: a cross-sectional, case-control study of 158 patients with type 2 diabetes and different degrees of urinary albumin excretion.  Diabetes. 2006;  55 1456-1462
  • 23 Matsumoto H, Nakao T, Okada T. et al . Insulin resistance contributes to obesity-related proteinuria.  Int Med. 2005;  44 548-553
  • 24 Praga M, Hernandez E, Morales E. et al . Clinical features and long-term outcome of obesity-associated focal segmental glomerulosclerosis.  Nephrol Dial Transplant. 2001;  16 1790-1798
  • 25 Scaglione R, Ganguzza A, Corrao S. et al . Central obesity and hypertension: Pathophysiologic role of renal haemodynamics and function.  Int J Obes Relat Metab Disord. 1995;  19 403-409
  • 26 Verani RR. Obesity-associated focal segmental glomerulosclerosis: pathological features of the lesion and relationship with cardiomegaly and hyperlipidemia.  Am J Kidney Dis. 1992;  6 629-634
  • 27 Kasiske BL, O’Donnell MP, Cleary MP. et al . Treatment of hyperlipidemia reduced glomerular injury in obese Zucker rats.  Kidney Int. 1998;  33 667-672
  • 28 Pi-Sunyer FX. The epidemiology of central fat distribution in relation to disease.  Nutr Rev. 2004;  62 S120-S126

Correspondence

Z. Liu

Research Institute of Nephrology

Jinling Hospital

Medical School

Nanjing University

210002 Nanjing

P. R. China

Phone: +86/25/8086 02 18

Fax: +86/25/8480 19 92

Email: zhihong@21cn.net