Correlation Between Renal Sinus Fat Volume And Diabetic Kidndy Disease In Type 2 Diabetes Mellitus Patients

Objective To study the relationship between renal sinus fat(RSF)with estimated glomerular filtration rate(e GFR)and urine albumin to creatinine ratio(UACR)in patients with type 2 diabetes mellitus(T2DM).Methods We recruited 260 hospitalized T2DM patients in The First Affiliated Hospital of Chongqing Medical University from January 2014 to July 2018 in this study.Firstly,the patients were divided into three groups according to e GFR level,and the general clinical data and biochemical parameters were compared among the groups.Then,the patients were divided into 2 groups according to the volume of the RSF which were assessed with Computed Tomography.then comparing the general clinical data and biochemical parameters between the two groups.The t test orχ~2test were used to compare among the different groups.Pearson correlation analysis was used to further determine the effects of RSF on e GFR and UACR.Finally,multivariate linear regression analysis was used to correct and analyze whether RSF was independently related to e GFR and UACR.Results 1、260 T2DM patients were divided into three groups according to e GFR levels by tertiles method.With the increasing e GFR level,the RSF showed a statistically significant downward trend(P=0.034),and the average volume of RSF in the three groups was respectively12.6(7.3,17.3)cm~3,12.1(7.3,18.4)cm~3and 9.65(4.3,17.6)cm~3.Meanwhile,comparison of general clinical data and biochemical parameters,the age,history of hypertension(HBP),serum creatinine,serum uric acid,UACR and the antihypertensive drugs also showed a downward trend with the increase of e GFR level(P<0.05).2、260 T2DM patients were divided into low and high percentile groups according to volume of RSF,compared with the low percentile group,there was a larger proportion of male patients[68.5%(89/130)vs43.8%(57/130)],with long HBP,smoking and drinking history in high percentile group.Body mass index[25.0(22.8,28.4)vs 24.0(21.5,26.2)kg/m~2]and blood uric acid levels[326(277,388)vs 293(228,361)μmol/L]were higher in high percentile group,while the level of high density lipoprotein cholesterol(HDL-C)[0.90(0.80,1.20)vs 1.00(0.90,1.38)mmol/L]and e GFR[(85.2±30.3)vs(93.0±29.4)ml/min/1.73 m~2]were significantly lower in high percentile group(all P<0.05).3、The univariate linear correlation analysis showed that e GFR were positively correlated with fasting plasma glucose,glycated hemoglobin A1c,low-density lipoprotein-cholesterol and HDL-C(r=0.160,0.166,0.134,0.143,all P<0.05),whereas negatively correlated with gender,age,duration of diabetes,HBP,serum creatinine,serum uric acid,RSF and UACR(r=-0.587～-0.134,all P<0.05).4、After adjusted for gender,age,duration of diabetes,body mass index,relative metabolism and drugs influencing factors,the multiple linear regression analysis revealed that RSF was inversely related with e GFR(β=-0.155,P=0.021)and but not with UACR(β=0.136,P=0.073).Conclusion In Chinese T2DM patients,the RSF is independently related to the decline of e GFR.