Key result
Higher trunk fat mass links to lower GFR and ERPF in type 1 diabetes.
Why the study?
Does central adiposity impact intrarenal hemodynamic function in adults with long-standing type 1 diabetes?
Observational (n=139)
Does central adiposity impact intrarenal hemodynamic function in adults with long-standing type 1 diabetes?
Central adiposity is associated with worse intrarenal hemodynamic function in patients with long-standing type 1 diabetes, an effect not observed in healthy controls.
Answers are grounded in this paper and cite their sources.
Trunk fat mass was associated with lower GFR and ERPF in long-standing type 1 diabetes; hypothesis-generating observation that leaves open any causal role.
OBJECTIVE Central adiposity is considered to be an important cardiorenal risk factor in the general population and in type 1 diabetes. We sought to determine the relationship between central adiposity and intrarenal hemodynamic function in adults with long-standing type 1 diabetes with and without diabetic nephropathy (DN). RESEARCH DESIGN AND METHODS Patients with type 1 diabetes (n = 66, duration ≥50 years) and age-/sex-matched control subjects (n = 73) were studied. The cohort was stratified into 44 DN Resistors (estimated glomerular filtration rate [eGFR] >60 mL/min/1.73 m2 and <30 mg/day urine albumin) and 22 patients with DN (eGFR ≤60 mL/min/1.73 m2 or ≥30 mg/day urine albumin). Intrarenal hemodynamic function (glomerular filtration rate for inulin [GFRINULIN], effective renal plasma flow for p-aminohippuric acid [ERPFPAH]) was measured. Afferent arteriolar resistance, efferent arteriolar resistance, renal blood flow, renal vascular resistance [RVR], filtration fraction, and glomerular pressure were derived from the Gomez equations. Fat and lean mass were quantified by DXA. RESULTS Whereas measures of adiposity did not associate with GFRINULIN or ERPFPAH in healthy control subjects, trunk fat mass inversely correlated with GFRINULIN (r = −0.46, P < 0.0001) and ERPFPAH (r = −0.31, P = 0.01) and positively correlated with RVR (r = 0.53, P = 0.0003) in type 1 diabetes. In analyses stratified by DN status, greater central adiposity related to lower GFRINULIN values in DN and DN Resistors, but the relationships between central adiposity and ERPFPAH and RVR were attenuated and/or reversed in patients with DN compared with DN Resistors. CONCLUSIONS The adiposity-intrarenal hemodynamic function relationship may be modified by the presence of type 1 diabetes and DN, requiring further study of the mechanisms by which adiposity influences renal hemodynamic function.
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Bjornstad et al. (2018) conducted an observational in Type 1 diabetes with and without diabetic nephropathy (n=139). Central adiposity (trunk fat mass) vs. Healthy control subjects was evaluated on Correlation between trunk fat mass and GFRINULIN in type 1 diabetes (r = -0.46, p=< 0.0001). In adults with long-standing type 1 diabetes, trunk fat mass inversely correlated with glomerular filtration rate and effective renal plasma flow.
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