Kidney Week

Abstract: TH-PO1055

Associations of Adiposity with Albuminuria in South Asian Adults

Session Information

• CKD: Epidemiology, Risk Factors, and Other Conditions
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Cui, Kathleen, University of California San Francisco, San Francisco, California, United States

Kathleen Cui

• Scherzer, Rebecca, University of California San Francisco, San Francisco, California, United States

Rebecca Scherzer, PhD

• Shlipak, Michael, University of California San Francisco, San Francisco, California, United States

Michael Shlipak, MD, MPH

• Estrella, Michelle M., University of California San Francisco, San Francisco, California, United States

Michelle M. Estrella, MD, MHS

• Kanaya, Alka M., University of California San Francisco, San Francisco, California, United States

Alka M. Kanaya, MD

• Gadgil, Meghana D, University of California San Francisco, San Francisco, California, United States

Meghana D Gadgil, MD, MPH

• Allison, Matthew, University of California San Diego, La Jolla, California, United States

Matthew Allison, MD, MPH

• Ding, Jingzhong, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States

Jingzhong Ding, PhD

• Post, Wendy S., Johns Hopkins University, Baltimore, Maryland, United States

Wendy S. Post, MD

• Chen, Teresa K., University of California San Francisco, San Francisco, California, United States

Teresa K. Chen, MD

Background

Compared with other race/ethnic groups, South Asian adults have more total and ectopic body fat on average even after accounting for BMI. We hypothesized that distinct fat depots would have different associations with albuminuria in this population.

Methods

In 902 South Asian participants from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, we used robust linear regression to compare cross-sectional associations of anthropometric (BMI, waist circumference [WC], waist-to-hip ratio) and direct (abdominal visceral, subcutaneous, and intermuscular fat areas; pericardial fat volume; hepatic fat attenuation by CT) measures of adiposity with spot urine albumin concentrations, adjusting for urine creatinine, sociodemographic, lifestyle, and clinical factors. We assessed differences in these associations by race/ethnic subgroups using harmonized data from 2709 MASALA and Multi-Ethnic Study of Atherosclerosis (MESA) participants.

Results

In MASALA, participants had a median age of 54 years and 20% had diabetes. Median BMI, WC, and eGFR were 25 kg/m², 92 cm, and 98 mL/min/1.73 m², respectively. WC correlated more strongly than BMI for most direct adiposity measures (e.g., -0.45 vs. -0.37 for hepatic fat attenuation and 0.65 vs. 0.50 for visceral fat area, respectively). Among all anthropometric and direct measures, only hepatic fat attenuation (indicating greater hepatic fat) was associated with urine albumin in fully adjusted models (3.1% per 1 SD; 95% CI: 1.03–5.3). This pattern appeared consistent across race/ethnic groups, reaching statistical significance in South Asian and White adults (Figure).

Conclusion

Among South Asian adults, hepatic fat, but not other measures of adiposity, was independently associated with higher urine albumin levels. These findings suggest that the differential distribution of adipose tissue may be an important risk factor for kidney disease.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025qp02bv0n