Fatty Kidney, Hypertension, and Chronic Kidney Disease The Framingham Heart Study

被引:276
作者
Foster, Meredith C. [1 ,2 ,3 ,4 ]
Hwang, Shih-Jen [1 ,2 ,3 ]
Porter, Stacy A. [6 ]
Massaro, Joseph M. [7 ]
Hoffmann, Udo [8 ]
Fox, Caroline S. [1 ,2 ,3 ,5 ]
机构
[1] Framingham Heart Dis Epidemiol Study, Framingham, MA USA
[2] NHLBI, Div Intramural Res, NIH, Bethesda, MD 20892 USA
[3] NHLBI, Ctr Populat Studies, NIH, Bethesda, MD 20892 USA
[4] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA
[5] Brigham & Womens Hosp, Div Endocrinol & Metab, Boston, MA 02115 USA
[6] Harvard Univ, Sch Med, Boston, MA USA
[7] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA USA
[8] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA
关键词
renal sinus fat; hypertension; chronic kidney disease; blood pressure; computed tomography; epidemiology; GLOMERULAR-FILTRATION-RATE; SERUM CYSTATIN-C; OBESITY-INDUCED HYPERTENSION; RENAL-VEIN CONSTRICTION; METABOLIC SYNDROME; ADIPOSE-TISSUE; BLOOD-PRESSURE; RISK-FACTORS; ASSOCIATION; CREATININE;
D O I
10.1161/HYPERTENSIONAHA.111.175315
中图分类号
R6 [外科学];
学科分类号
100210 [外科学];
摘要
Ectopic fat depots may mediate local and systemic disease. Animal models of diet-induced obesity demonstrate increased fat accumulation in the renal sinus. The association of renal sinus fat with hypertension, chronic kidney disease, and other metabolic disorders has not been studied in a large, community-based sample. Participants from the Framingham Heart Study (n = 2923; mean age: 54 years; 51% women) underwent quantification of renal sinus fat area using computed tomography. High renal sinus fat ("fatty kidney") was defined using sex-specific 90th percentiles in a healthy referent subsample. Multivariable linear and logistic regression was used to model metabolic risk factors as a function of fatty kidney and log-transformed renal sinus fat. Multivariable models were adjusted for age, sex, and outcome-specific covariates and then additionally adjusted for body mass index or abdominal visceral adipose tissue. The prevalence of fatty kidney was 30.1% (n = 879). Individuals with fatty kidney had a higher odds ratio (OR) of hypertension (OR: 2.12; P < 0.0001), which persisted after adjustment for body mass index (OR: 1.49; P < 0.0001) or visceral adipose tissue (OR: 1.24; P = 0.049). Fatty kidney was also associated with an increased OR for chronic kidney disease (OR: 2.30; P = 0.005), even after additionally adjusting for body mass index (OR: 1.86; P = 0.04) or visceral adipose tissue (OR: 1.86; P = 0.05). We observed no association between fatty kidney and diabetes mellitus after adjusting for visceral adipose tissue. In conclusion, fatty kidney is a common condition that is associated with an increased risk of hypertension and chronic kidney disease. Renal sinus fat may play a role in blood pressure regulation and chronic kidney disease. (Hypertension. 2011;58:784-790.). Online Data Supplement
引用
收藏
页码:784 / U266
页数:15
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