Abstract: SA-PO130

Adiposity and Renal Hemodynamic Function in Adults with Longstanding Type 1 Diabetes with and without Diabetic Kidney Disease

Session Information

Category: Diabetes

  • 503 Diabetes Mellitus and Obesity: Translational

Authors

  • Bjornstad, Petter, Children's Hospital Colorado, Aurora, Colorado, United States
  • Cham, Leslie, Universal Health Network, Toronto, Ontario, Canada
  • Orszag, Andrej, Sinai Health System, Toronto, Ontario, Canada
  • Weisman, Alanna, University of Toronto, Toronto, Ontario, Canada
  • Keenan, Hillary A., Joslin Diabetes Center, Boston, Massachusetts, United States
  • Brent, Michael, University of Toronto, Toronto, Ontario, Canada
  • Paul, Narinder, University Health Network, Toronto, Ontario, Canada
  • Bril, Vera, University of Toronto, Toronto, Ontario, Canada
  • Perkins, Bruce A., University of Toronto, Toronto, Ontario, Canada
  • Cherney, David, University of Toronto, Toronto, Ontario, Canada
  • Lovshin, Julie A, University of Toronto, Toronto, Ontario, Canada
  • Lytvyn, Yuliya, University of Toronto, Toronto, Ontario, Canada
  • Boulet, Genevieve, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital. Toronto, Ontario, Canada, Quebec City, Quebec, Canada
  • Lovblom, Leif Erik, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
  • Alhuzaim, Omar Nasser, University of Toronto, Toronto, Ontario, Canada
  • Farooqi, Mohammed A. Malik, None, Oakville, Ontario, Canada
  • Lai, Vesta S, University Health Network, Toronto, Ontario, Canada
  • Tse, Josephine, University Health Network, Toronto, Ontario, Canada
Background

Central adiposity is considered an important cardio-renal risk factor in the general population and in type 1 diabetes (T1D). We sought to determine the relationship between central adiposity and renal hemodynamic function in adults with longstanding T1D with and without diabetic nephropathy (DN).

Methods

Patients with longstanding T1D (n=75, duration >50 yrs) and age/sex-matched healthy controls (HC, n=75) were studied. The T1D cohort was stratified into 50 DN Resistors (eGFR >60mL/min/1.73m2 and <30 mg/day urine albumin) and 25 with DN. Renal hemodynamic function (glomerular filtration rate [GFRINULIN], effective renal plasma flow [ERPFPAH] was measured. Afferent arteriolar resistance (RA), efferent arteriolar resistance (RE), renal blood flow [RBF], renal vascular resistance [RVR], filtration fraction [FF], glomerular pressure (PGLO) derived from Gomez’ equations. Fat and lean mass were quantified by DXA.

Results

In healthy controls, measures of adiposity did not associate with GFRINULIN or ERPFPAH. In T1D, trunk fat mass inversely correlated with GFRINULIN (r: -0.46, p<0.0001), ERPFPAH (r: -0.31, p=0.01) and positively with RVR (r: 0.53, p=0.0003). In analyses stratified by DN status, greater central adiposity related to lower GFRINULIN in both DN and DN resistors, but the relationships between central adiposity, ERPFPAH and RVR were attenuated and/or reversed in DN compared to DN resistors. GFRINULIN across tertiles of trunk fat percentage are shown in Fig 1.

Conclusion

The adiposity-renal hemodynamic function relationship may be modified by the presence of T1D and of DN, requiring further study of the mechanisms by which adiposity influences renal hemodynamic function in health and disease.

Funding

  • NIDDK Support