title: Para- and perirenal ultrasonographic fat thickness is associated with 24-hours mean diastolic blood pressure levels in overweight and obese subjects.
abstract: BACKGROUND
  Renal sinus fat (RSF) has been recognized as a risk factor for arterial hypertension. This study was addressed to examine whether also para- and perirenal fat accumulation is associated to higher 24-h mean systolic (SBP) and/or diastolic blood pressure (DBP) levels in overweight and obese subjects.
  
  
  METHODS
  A cohort of 42 overweight and obese patients, 29 women and 13 men, aged 25-55 years, not treated with any kind of drug, was examined. Body mass index (BMI), waist circumference (WC), fasting insulin and glucose serum levels, insulin resistance (assessed by using the homeostasis model assessment [HOMAIR]), and 24-h aldosterone urine levels were measured. Ambulatory blood pressure monitoring (ABPM) was measured with 15 min intervals from 7.0 a.m. to 11.0 a.m. and with 30 min intervals from 23.0 to 7.0 for consecutive 24 h, starting from 8:30 AM. Measurement of para- and perirenal fat thickness was performed by ultrasounds by a duplex Doppler apparatus.
  
  
  RESULTS
  Para- and perirenal ultrasonographic fat thickness (PUFT) was significantly and positively correlated with WC (p < 0.01), insulin (p < 0.01), HOMAIR (p < 0.01), and 24-h mean DBP levels (p < 0.05). 24-h mean DBP was also significantly and positively correlated with 24-h aldosterone urine concentrations (p < 0.001). A multivariate analysis by multiple linear regression was performed; the final model showed that the association of 24-h mean DBP as dependent variable with PUFT (multiple R = 0.34; p = 0.026) and daily aldosterone production (multiple R = 0.59; p = 0.001) was independent of other anthropometric, hormone and metabolic parameters.
  
  
  CONCLUSIONS
  This study shows a positive independent association between PUFT and mean 24-h diastolic blood pressure levels in overweight and obese subjects, suggesting a possible direct role of PUFT in increasing daily diastolic blood pressure.
authors.affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy. gdepergola@libero.it.|Department of Emergency and Organ Tranplantation (DETO), Section of Nephrology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy. gdepergola@libero.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Pergola
authors.affiliation: Department of Emergency and Organ Tranplantation (DETO), Section of Nephrology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy. niclacam@libero.it.
authors.forename: Nicla
authors.initials: N
authors.lastname: Campobasso
authors.affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy. a.nardecchia@teletu.it.
authors.forename: Adele
authors.initials: A
authors.lastname: Nardecchia
authors.affiliation: Department of Emergency and Organ Tranplantation (DETO), Section of Endocrinology and Metabolic Diseases, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy. vincenzo.triggiani@uniba.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Triggiani
authors.affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy. dott.caccavo@gmail.com.
authors.forename: Domenico
authors.initials: D
authors.lastname: Caccavo
authors.affiliation: Department of Emergency and Organ Tranplantation (DETO), Section of Nephrology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy. loreto.gesualdo@uniba.it.
authors.forename: Loreto
authors.initials: L
authors.lastname: Gesualdo
authors.affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Biomedical Sciences and Human Oncology, Section of Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy. francesco.silvestris.@uniba.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Silvestris
authors.affiliation: Department of Emergency and Organ Tranplantation (DETO), Section of Nephrology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare, 70124, Bari, Italy. carlo.manno@uniba.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Manno
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000450:Aldosterone / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D050177:Overweight / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012307:Risk Factors; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D007328:Insulin; D000450:Aldosterone