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Predictors of the early impairment of renal disease in human obesity

International Journal of Obesity volume 34, pages 287–294 (2010)Cite this article

Abstract

Objective:

The mechanisms underlying the association of the increased albumin excretion rate (AER) with adiposity have yet to be clarified. We therefore investigated (1) the predictors of AER after 3 months of lifestyle intervention in a large cohort of nondiabetic obese women and (2) the relationships between AER and the adipose tissue gene expression of adipokines linked to inflammation and insulin resistance.

Subjects:

A total of 269 obese nondiabetic women (age 49.9±13.1 years, body mass index (BMI) 36.8±4.6 kg m−2) participated in this program. Measurements used were anthropometrics parameters, blood pressure, oral glucose tolerance test, lipids, creatinine, AER, homeostasis model assessment of insulin resistance (HOMA-IR) and glomerular filtration rate at baseline and after 3 months of lifestyle intervention. At baseline, in a subgroup of 34 women, subcutaneous adipose tissue biopsy was carried out for the analysis of mRNA expression levels of adiponectin, suppressor of cytokine signaling 3 (SOCS-3), tumor necrosis factor α (TNF-α), pentraxine 3 (PTX-3), angiotensinogen and angiotensin-converting enzyme, and a blood sample was also taken from this group for the measurement of circulating adiponectin, interleukin-6, TNF-α and PTX-3. Microalbuminuria was defined as albumin/creatinine ratio ⩾3.5 mg mmol−1. Real-time PCR was used to quantify mRNA.

Results:

Six percent of obese women had microalbuminuria. When dividing the whole cohort into three groups according to AER changes (decrease, stability and increase), we noted that 2 h glucose, insulin and HOMA-IR significantly decreased (P<0.05 for all) only in women who had a decrease in AER, whereas BMI and waist circumference significantly decreased in all the three groups (P<0.05). At baseline, higher AER was associated to significantly higher adipose tissue mRNA expression levels of SOCS-3 and PTX-3 (P<0.05) and to higher TNF-α and angiotensinogen expression.

Conclusions:

In obese women, weight loss alone is not sufficient to induce the AER decrease that occurs only with a concomitant improvement in glucose homeostasis. The adipose tissue gene expression profile seems to favor the early renal impairment often seen in obese subjects.

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Authors and Affiliations

  1. Unit for Metabolic Diseases and Diabetes, Istituto Auxologico Italiano, Milan, Italy

    L Gilardini, A Zulian, A Girola, G Redaelli, A Conti & C Invitti

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  1. L Gilardini
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Gilardini, L., Zulian, A., Girola, A. et al. Predictors of the early impairment of renal disease in human obesity. Int J Obes 34, 287–294 (2010). https://doi.org/10.1038/ijo.2009.227

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