Para- and perirenal ultrasonographic fat thickness is associated with 24-hours mean diastolic blood pressure levels in overweight and obese subjects

BMC Cardiovascular Disorders

Carlo Manno³  Franco Silvestris²  Loreto Gesualdo³  Domenico Caccavo²  Vincenzo Triggiani¹  Adele Nardecchia²  Nicla Campobasso³  Giovanni De Pergola³ 

[1]Department of Emergency and Organ Tranplantation (DETO), Section of Endocrinology and Metabolic Diseases, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, Bari, 70124, Italy

[2]Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, Bari, 70124, Italy

[3]Department of Emergency and Organ Tranplantation (DETO), Section of Nephrology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, Bari, 70124, Italy

关键词: Para- and perirenal ultrasonographic fat thickness;    Obesity;    Hypertension;    Ambulatory blood pressure monitoring;    Aldosterone;   

Others  :  1228290
DOI  :  10.1186/s12872-015-0101-6

 received in 2015-04-10, accepted in 2015-09-21,  发布年份 2015

【 摘 要 】

Background

Renal sinus fat (RSF) has been recognized as a risk factor for arterial hypertension. This study was addressed to examine whether also para- and perirenal fat accumulation is associated to higher 24-h mean systolic (SBP) and/or diastolic blood pressure (DBP) levels in overweight and obese subjects.

Methods

A cohort of 42 overweight and obese patients, 29 women and 13 men, aged 25–55 years, not treated with any kind of drug, was examined. Body mass index (BMI), waist circumference (WC), fasting insulin and glucose serum levels, insulin resistance (assessed by using the homeostasis model assessment [HOMAIR]), and 24-h aldosterone urine levels were measured. Ambulatory blood pressure monitoring (ABPM) was measured with 15 min intervals from 7.0 a.m. to 11.0 a.m. and with 30 min intervals from 23.0 to 7.0 for consecutive 24 h, starting from 8:30 AM. Measurement of para- and perirenal fat thickness was performed by ultrasounds by a duplex Doppler apparatus.

Results

Para- and perirenal ultrasonographic fat thickness (PUFT) was significantly and positively correlated with WC (p < 0.01), insulin (p < 0.01), HOMAIR (p < 0.01), and 24-h mean DBP levels (p < 0.05). 24-h mean DBP was also significantly and positively correlated with 24-h aldosterone urine concentrations (p < 0.001). A multivariate analysis by multiple linear regression was performed; the final model showed that the association of 24-h mean DBP as dependent variable with PUFT (multiple R = 0.34; p = 0.026) and daily aldosterone production (multiple R = 0.59; p = 0.001) was independent of other anthropometric, hormone and metabolic parameters.

Discussion and Conclusions

This study shows a positive independent association between PUFT and mean 24-h diastolic blood pressure levels in overweight and obese subjects, suggesting a possible direct role of PUFT in increasing daily diastolic blood pressure.

【 授权许可】

   
2015 De Pergola et al.

【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

【 参考文献 】

• [1]Cornier M-A, Marshall JA, Hill JO, Maahs DM, Eckel RH: Prevention of overweight/obesity as a strategy to optimize cardiovascular health. Circulation 2011, 124:840-50.
• [2]Balagopal P, de Ferranti SD, Cook S, Daniels SR, Gidding SS, Hayman LL, et al.: Nontraditional risk factors and biomarkers for cardiovascular disease: mechanistic, research, and clinical considerations for youth. Circulation 2011, 123:2749-69.
• [3]Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, Bingham S, et al.: Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation 2007, 116:2933-43.
• [4]Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation 2002; 106: 3143.
• [5]Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al.: Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007, 116:39-48.
• [6]Britton KA, Fox CS: Ectopic Fat Depots and Cardiovascular Disease. Circulation 2011, 124:e837-e41.
• [7]Heilbronn L, Smith S, Ravussin E: Failure of fat cell proliferation, mitochondrial function and fat oxidation results in ectopic fat storage, insulin resistance and type II diabetes mellitus. Int J Obes Relat Metab Disord 2004, 28(suppl 4):S12-S21.
• [8]Lamacchia O, Nicastro V, Camarchio D, Valente U, Grisorio R, Gesualdo L, et al.: Para- and perirenal fat thickness is an independent predictor of chronic kidney disease, increased renal resistance index and hyperuricaemia in type-2 diabetic patients. Nephrol Dial Transplant 2011, 26:892-8.
• [9]Chughtai HL, Morgan TM, Rocco M, Stacey B, Brinkley TE, Ding J, et al.: Renal sinus fat and poor BP control in middle-aged and elderly individuals at risk for cardiovascular events. Hypertension 2010, 56:901-6.
• [10]Dwyer TM, Mizelle HL, Cockrell K, Buhner P: Renal sinus lipomatosis and body composition in hypertensive, obese rabbits. Int J Obes Relat Metab Disord 1995, 19:869-74.
• [11]Montani JP, Carroll JF, Dwyer TM, Antic V, Yang Z, Dulloo AG: Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Disord 2004, 28(S4):S58-S65.
• [12]Foster MC, Hwang S-J, Porter SA, Massaro JM, Hoffmann U, Fox CS: Fatty kidney, hypertension, and chronic kidney disease: the Framingham Heart Study. Hypertension 2011, 58:784-90.
• [13]Bonora E, Targher G, Alberiche M, Bonadonna RC, Saggiani F, Zenere MB, et al.: Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000, 23:57-63.
• [14]De Pergola G, Nardecchia A, Guida P, Silvestris F: Arterial hypertension in obesity: relationships with hormone and anthropometric parameters. Eur J Cardiovasc Prev Rehabil 2011, 18:240-7.
• [15]Rossi GP, Belfiore A, Bernini G, Fabris B, Caridi G, Ferri C, et al.: Body mass index predicts plasma aldosterone concentrations in overweight-obese primary hypertensive patients. J Clin Endocrinol Metab 2008, 93:2566-71.