Associations of renal sinus fat with metabolic parameters, abdominal visceral adipose tissue, metabolic syndrome, fructose intake, and blood pressure control in obese individuals with hypertension: a cross-sectional study

Abstract

Renal sinus fat (RSF) crucially influences metabolic regulation, inflammation, and vascular function. We investigated the association between RSF accumulation, metabolic disorders, and nutritional status in obese individuals with hypertension. A cross-sectional study involved 51 obese hypertensive patients from Salamat Specialized Community Clinic (February-September 2022). Basic and clinical information were collected through interviews. Data included anthropometrics, blood pressure, number of antihypertensive medications, body composition (bioelectrical impedance analysis), dietary intake (semi-quantitative 147-item food frequency questionnaire), and blood samples. Renal sinus fat was measured via ultrasonography. Statistical analyses included Pearson correlation, binary logistic regression, and linear regression. RSF positively correlated with abdominal visceral adipose tissue (VAT) area (P = 0.016), systolic blood pressure (SBP) (P = 0.004), and diastolic blood pressure (DBP) (P = 0.005). A strong trend toward a positive association was observed between antihypertensive medications and RSF (P = 0.062). In linear regression, RSF was independently associated with abdominal VAT area, SBP, and DBP after adjusting for confounders. After considering other risk factors, RSF volume relates to prescribed antihypertensive medications, hypertension, and central fat accumulation in obese hypertensive subjects. These findings suggest the need for further investigations into whether RSF promotes metabolic disorders.

Keywords: ACE, angiotensin converting enzyme; ALT, alanine transaminase; ARB, angiotensin II receptor blockers; AST, aspartate transaminase; BIA, bioelectrical impedance analysis; BMI, body mass index; CCB, calcium channel blockers; CKD, chronic kidney disease; CT, computed tomography; DBP, diastolic blood pressure; FBS, fasting blood sugar; FCT, food composition table; FFQ, food frequency questionnaire; Fructose; HDL-C, high-density lipoprotein cholesterol; HFCS, high-fructose corn syrup; HOMA-IR, homeostasis model assessment of insulin resistance; Hypertension; IDF, international diabetes federation; IL-6, interleukin-6; LDL-C, low-density lipoprotein cholesterol; MRI, magnetic resonance imaging; MetS, metabolic syndrome; Metabolic syndrome; Obesity; PUFT, para- and perirenal ultrasonographic fat thickness; PVAT, perivascular adipose tissue; RAAS, renin-angiotensin-aldosterone system; RSF, renal sinus fat; Renal sinus fat; SAAT, subcutaneous abdominal adipose tissue; SBP, systolic blood pressure; SD, standard deviation; TC, total cholesterol; TG, triglycerides; TNF-α, tumour necrosis factor-alpha; USDA, United States Department of Agriculture; VAT, visceral adipose tissue; VLDL, very-low-density lipoprotein; Visceral adipose tissue; WHR, waist to hip ratio; eGFR, estimated glomerular filtration rate.