Relationship of para- and perirenal fat and epicardial fat with metabolic parameters in overweight and obese subjects

Background The accumulation of visceral body fat, has been shown to be associated with higher risk of metabolic and cardiovascular disease. This study was addressed to examine whether para- and perirenal fat thickness and epicardial fat thickness were correlated with anthropometric- and cardiometabolic risk factors. A cohort of 102 uncomplicated overweight and obese patients was examined. BMI, waist circumference, blood pressure, fasting insulin, glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol serum levels, and insulin resistance (assessed by HOMA(IR)) were measured. Para- and perirenal fat thickness (PUFT) and epicardial fat thickness (EUFT) were measured by ultrasounds. PUFT was positively correlated with BMI (p < 0.001), waist circumference (p < 0.001), insulin (p < 0.001), HOMA(IR) (p < 0.001), triglycerides (p < 0.05), systolic (p < 0.05) and diastolic (p < 0.05) blood pressure, and negatively correlated with HDL-cholesterol (p < 0.01). EUFT was positively associated with age (p < 0.01), BMI (p < 0.001), waist circumference (p < 0.001), systolic (p < 0.01) and diastolic (p < 0.001) blood pressure, and LDL-cholesterol (p < 0.05). A multivariate analysis by multiple linear regression was performed, and the final model showed a direct association of waist circumference with both PUFT and EUFT, a correlation of PUFT with HOMA(IR) (positive) and HDL-cholesterol (negative), and a direct association of EUFT (both long axis and short axis) with LDL-cholesterol. All these correlations were independent of other anthropometric, metabolic and hemodynamic parameters. This study shows that accumulation of central fat in apparently healthy overweight and obese subjects is associated to a simultaneous increase of pararenal, perirenal and epicardial fat. Moreover, it shows that only para- and perirenal fat is independently associated to insulin resistance and lower HDL-cholesterol, and only epicardial fat is independently associated to higher LDL cholesterol. Level of evidence Level V, cross-sectional descriptive study.