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Kidney Week

Abstract: SA-PO824

Abdominal Fat, Physical Function, and Their Associations with Insulin Resistance, Inflammation, and Adipokines in CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Navaneethan, Sankar D., CRIC VAP Study team, Houston, Texas, United States
  • Kirwan, John P., CRIC VAP Study team, Houston, Texas, United States
  • Remer, Erick M., CRIC VAP Study team, Houston, Texas, United States
  • Schneider, Erika, CRIC VAP Study team, Houston, Texas, United States
  • Addeman, Bryan, CRIC VAP Study team, Houston, Texas, United States
  • Arrigain, Susana, CRIC VAP Study team, Houston, Texas, United States
  • Fink, Jeffrey C., CRIC VAP Study team, Houston, Texas, United States
  • Lash, James P., CRIC VAP Study team, Houston, Texas, United States
  • Mckenzie, Charlie, CRIC VAP Study team, Houston, Texas, United States
  • Rahman, Mahboob, CRIC VAP Study team, Houston, Texas, United States
  • Rao, Panduranga S., CRIC VAP Study team, Houston, Texas, United States
  • Schold, Jesse D., CRIC VAP Study team, Houston, Texas, United States
  • Shafi, Tariq, CRIC VAP Study team, Houston, Texas, United States
  • Taliercio, Jonathan J., CRIC VAP Study team, Houston, Texas, United States
  • Townsend, Raymond R., CRIC VAP Study team, Houston, Texas, United States
  • Feldman, Harold I., CRIC VAP Study team, Houston, Texas, United States
Background

Adiposity and physical inactivity are major drivers of cardiometabolic risk, and may confer differential metabolic risk profile in CKD. We examined the associations of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and physical function with inflammation, insulin resistance, adipokines in those with CKD.

Methods

We obtained MRI of the abdomen and pelvis, and 400m walk test to assess the VAT, SAT volume and physical function among 419 CRIC study participants using a standardized protocol. We also measured markers of inflammation (IL-beta, IL-6, TNF-R1, and TNF-R2), insulin resistance (HOMA-IR), and adipokines (adiponectin- total and HMW, resistin, and leptin). We evaluated the associations between VAT, SATvolume and physical function, and individual markers (log-transformed values) adjusting for relevant confounders.

Results

Mean age of the study population (n=419) was 64.3 years; 40% were females, and the mean eGFR was 55.7 (+/- 18.4) ml/min/1.73 m2. Over 85% of them were overweight or obese, and 39% were diabetics. Each SD higher VAT and SAT were associated with lower levels of total and HMW adiponectin, and higher levels of leptin and insulin resistance [Figure]. However, higher 400m walk time was associated only with higher levels of plasma IL-6 and TNFR-1 [Figure].

Conclusion

The observations that greater adiposity is associated with altered adipokine profile and insulin resistance, while lower levels of physical function are related to enhanced inflammation in CKD are intriguing. A deeper understanding of the reasons for these differential associations may lead to new approaches to management of patients with CKD.

Funding

  • NIDDK Support