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Abstract: TH-PO229

Kidney Fat by Magnetic Resonance Spectroscopy in Type 2 Diabetes and Diabetic Kidney Disease

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Heinrich, Niels Sondergaard, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Pedersen, Rune Ploegstra, Rigshospitalet, Kobenhavn, Denmark
  • Lindberg, Ulrich, Rigshospitalet, Kobenhavn, Denmark
  • Andersen, Ulrik B., Rigshospitalet, Kobenhavn, Denmark
  • Haddock, Bryan, Rigshospitalet, Kobenhavn, Denmark
  • Hansen, Tine, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Fornoni, Alessia, University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
Background

Ectopic fat is a major pathogenic factor in type 2 diabetes (T2D). The kidneys may be susceptible to ectopic fat and its lipotoxic effects, disposing them toward chronic kidney disease (CKD). In few smaller studies, using discrepant magnetic resonance methods, intra-kidney fat content appeared to be slightly higher in people with T2D and perhaps even higher with concomitant CKD. We investigated the reproducibility of these findings.

Methods

Cross-sectional study including 50 adults with T2D and CKD, 27 with T2D and no CKD and 29 without T2D or CKD; CKD defined as urine albumin creatinine ratio ≥ 30mg/g. Fat content in the kidney parenchyma was assessed by magnetic resonance spectroscopy (MRS) in a 3 Tesla MRI scanner with a single voxel point resolved spectroscopy sequence; echo time 40 ms repetition time 3000 ms.

Results

See descriptive statistics in Table. In preliminary MRS data, median [IQR] intra-kidney triglyceride content was 1.1 [0.2-2.0]%, 1.0 [0.5-1.7]% and 1.7 [0.6-3.4]% (p = 0.08; Kruskal-Wallis test), respectively, in the T2D and CKD, T2D but no CKD and non-T2D groups. In linear regression adjusting for age and sex, there were likewise no associations between groups and triglyceride content.

Conclusion

In T2D with or without CKD we found no trend toward higher intra-kidney fat when evaluated by MRS, despite higher body mass index. Intra-kidney fat content was generally minuscule, making differences difficult to detect. The use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, mostly among T2D participants with CKD, may have affected the results as these agents may reduce ectopic fat. It is also possible that lipid species other than triglyceride differ across the three groups.

 Type 2 diabetes with chronic kidney disease (n=50)Type 2 diabetes without chronic kidney disease (n=27)No type 2 diabetes or chronic kidney disease (n=29)
Age, years, mean ± SD67 ± 766 ± 1066 ± 8
Men, n422112
Body mass index, kg/m2, mean ± SD31 ± 429 ± 426 ± 5
Diabetes duration, years, median [IQR]19 [11-26]17 [10-24]NA
Urine albumin creatinine ratio, mg/g, median [IQR]95 [42-291]6 [5-10]5 [4-6]
Estimated glomerular filtration rate, ml/min/1.73m2, mean ± SD 76 ± 22 94 ± 1189 ± 11
Sodium-glucose cotransporter-2 inhibitor, n35130
Glucagon-like peptide-1 receptor agonist, n33170

Funding

  • Private Foundation Support