title: Exercise-induced albuminuria is associated with perivascular renal sinus fat in individuals at increased risk of type 2 diabetes.
abstract: OBJECTIVE
  Microalbuminuria represents an established surrogate marker of early diabetic nephropathy and glomerular microangiopathy. Increasing evidence is emerging of a role of perivascular adipose tissue (PVAT) as an important link between obesity, insulin resistance and both macro- and microangiopathy. It is not known whether perivascular renal sinus fat (RSF) has an impact on microalbuminuria in the prediabetic stage. We investigated whether RSF quantified by MRI is associated with microalbuminuria before or after exercise.
  
  
  METHODS
  Non-diabetic individuals at increased risk of type 2 diabetes were recruited into the Tübingen Lifestyle Intervention Program (TULIP); 146 participants took part in the analysis. RSF was measured in axial MRI sections at the level of the renal artery. Urine was collected before and after exercise stress testing.
  
  
  RESULTS
  Participants (age 47 ± 12 years; mean ± SD) reached a mean exercise load of 176 ± 49 W, with a mean arterial peak pressure (MAPP) of 112 ± 14 mmHg. After adjusting for sex, age, visceral adipose tissue (VAT) and MAPP during exercise, RSF was significantly associated with postexercise albumin/creatinine ratio (ACR; p = 0.006). No association between RSF and baseline BP could be observed after adjusting for confounders (p = 0.26), and there was no association between RSF and baseline ACR either (p = 0.2).
  
  
  CONCLUSIONS
  RSF is associated with exercise-induced albuminuria independently of sex, age, VAT and MAPP in a non-diabetic cohort at diabetic risk. We conclude that PVAT in the renal sinus may play a role in the pathogenesis of microalbuminuria.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Angiology, Nephrology and Clinical Chemistry, Eberhard Karls University Tübingen, Otfried-Müller-Str 10, 72076 Tübingen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Wagner
authors.forename: J
authors.initials: J
authors.lastname: Machann
authors.forename: R
authors.initials: R
authors.lastname: Lehmann
authors.forename: K
authors.initials: K
authors.lastname: Rittig
authors.forename: F
authors.initials: F
authors.lastname: Schick
authors.forename: J
authors.initials: J
authors.lastname: Lenhart
authors.forename: F
authors.initials: F
authors.lastname: Artunc
authors.forename: K
authors.initials: K
authors.lastname: Linder
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.forename: E
authors.initials: E
authors.lastname: Schleicher
authors.forename: A
authors.initials: A
authors.lastname: Fritsche
authors.forename: H-U
authors.initials: HU
authors.lastname: Häring
authors.forename: P
authors.initials: P
authors.lastname: Weyrich
mesh_terms: D000419:Albuminuria / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D003404:Creatinine / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000652:urine; D003928:Diabetic Nephropathies / Q000209:etiology / Q000503:physiopathology / Q000652:urine*; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D007674:Kidney Diseases / Q000503:physiopathology / Q000652:urine*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
chemical_list: D001786:Blood Glucose; D003404:Creatinine