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156 INCREASED VISCERAL ADIPOSITY IS ASSOCIATED WITH DECREASED GLOMERULAR FILTRATION RATE BY A MECHANISM INDEPENDENT OF GLUCOSE TOLERANCE.
  1. F. Gerchman,
  2. J. Tong,
  3. K. M. Utzschneider,
  4. M. J. McNeely,
  5. R. L. Hull,
  6. S. Zraika,
  7. J. Udayasankar,
  8. D. J. Leonetti,
  9. E. J. Boyko,
  10. W. Y. Fujimoto,
  11. S. E. Kahn
  1. VA Puget Sound Health Care System and University of Washington, Seattle, WA

Abstract

Background Central adiposity is known to be associated with decreased glucose tolerance and has been suggested to be associated with reduced glomerular filtration rate (GFR).

Methods To determine whether abnormalities of GFR occur in the early stages of glucose intolerance and are related to visceral adiposity, we examined 406 Japanese Americans (62.0 ± 5.9 y, mean ± SD, 44.6% female) who had normal glucose tolerance (NGT; n = 144, 61.7 ± 5.9 y, 47.2% female), impaired glucose tolerance (IGT; n = 137, 62.1 ± 6.0 y and 46.0% female) and diabetes (DM; n = 125, 62.3 ± 5.9 y, 36.8% female; duration 2.8 ± 10.1 y, median 138} interquartile range [IQR]). Intra-abdominal fat (IAF) area was quantified by CT scan. The relationships between GFR, calculated using the Modification of Diet in Renal Disease (MDRD) formula, obesity, visceral adiposity, and glucose tolerance were analyzed.

Results BMI (23.9 ± 2.9 vs 24.6 ± 3.3 vs 25.5 ± 3.0 kg/m2, p < .0001) and IAF (85.9 ± 73.2 vs 101.9 ± 68.2 vs 122.1 ± 66.2 cm2, median ± IQR), p < .0001) increased from NGT to IGT to DM. No difference in GFR was detected between glucose tolerance groups (78.8 ± 18.0 vs 78.5 ± 18.7 vs 79.2 ± 20.4 mL/min per 1.73 m2, median ± IQR, p = .736). While IAF was correlated with the 2-hour glucose during an oral glucose tolerance test (r = .282, p < .0001), GFR was not associated with the 2-hour glucose (r = -.069, p = .164). GFR was inversely correlated with IAF (r = -.117, p = .018) and BMI (r = -.112, p = .024), and these associations remained significant after adjusting for 2-hour glucose.

Conclusion Increased visceral adiposity is associated with reduced GFR by a mechanism that appears independent of glucose tolerance.

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