Changes of renal sinus fat and renal parenchymal fat during an 18-month randomized weight loss trial

Hila Zelicha, Dan Schwarzfuchs, Ilan Shelef, Yftach Gepner, Gal Tsaban, Lilac Tene, Anat Yaskolka Meir, Avital Bilitzky, Oded Komy, Noa Cohen, Nitzan Bril, Michal Rein, Dana Serfaty, Shira Kenigsbuch, Yoash Chassidim, Benjamin Sarusi, Joachim Thiery, Uta Ceglarek, Michael Stumvoll, Matthias BlüherYosef S. Haviv, Meir J. Stampfer, Assaf Rudich, Iris Shai

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background & aims: Data regarding the role of kidney adiposity, its clinical implications, and its dynamics during weight-loss are sparse. We investigated the effect of long-term weight-loss induced intervention diets on dynamics of renal-sinus-fat, an ectopic fat depot, and %renal-parenchymal-fat, lipid accumulation within the renal parenchyma. Methods: We randomized 278 participants with abdominal obesity/dyslipidemia to low-fat or Mediterranean/low-carbohydrate diets, with or without exercise. We quantified renal-sinus-fat and %renal-parenchymal-fat by whole body magnetic-resonance-imaging. Results: Participants (age = 48 years; 89% men; body-mass-index = 31 kg/m2) had 86% retention to the trial after 18 months. Both increased renal-sinus-fat and %renal-parenchymal-fat were directly associated with hypertension, and with higher abdominal deep-subcutaneous-adipose-tissue and visceral-adipose-tissue (p of trend < 0.05 for all) after adjustment for body weight. Higher renal-sinus-fat was associated with lower estimated-glomerular-filtration-rate and with higher microalbuminuria and %HbA1C beyond body weight. After 18 months of intervention, overall renal-sinus-fat (−9%; p < 0.05 vs. baseline) but not %renal-parenchymal-fat (−1.7%; p = 0.13 vs. baseline) significantly decreased, and similarly across the intervention groups. Renal-sinus-fat and %renal-parenchymal-fat changes were correlated with weight-loss per-se (p < 0.05). In a model adjusted for age, sex, and visceral-adipose-tissue changes, 18 months reduction in renal-sinus-fat associated with decreased pancreatic, hepatic and cardiac fats (p < 0.05 for all) and with decreased cholesterol/high-density lipoprotein-cholesterol (HDL-c) (β = 0.13; p = 0.05), triglycerides/HDL-c (β = 0.13; p = 0.05), insulin (β = 0.12; p = 0.05) and gamma glutamyl transpeptidase (β = 0.24; p = 0.001), but not with improved renal function parameters or blood pressure. Decreased intake of sodium was associated with a reduction in %renal-parenchymal-fat, after adjustment for 18 months weight-loss (β = 0.15; p = 0.026) and hypertension (β = 0.14; p = 0.04). Conclusions: Renal-sinus-fat and renal-parenchymal-fat are fairly related to weight-loss. Decreased renal-sinus-fat is associated with improved hepatic parameters, independent of changes in weight or hepatic fat, rather than with improved renal function or blood pressure parameters. ClinicalTrials.govIdentifier: NCT01530724.

Original languageEnglish
Pages (from-to)1145-1153
Number of pages9
JournalClinical Nutrition
Volume37
Issue number4
DOIs
StatePublished - 1 Aug 2018

Keywords

  • Cardiometabolic risk
  • Magnetic-resonance-imaging
  • Renal-parenchymal-fat
  • Renal-sinus-fat
  • Weight-loss

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

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