This thesis shows the potential utility of imaging biomarkers of the heart, kidneys, and visceral adiposity in the clinical management of cardiorenal syndrome and type 2 diabetes. We explored the... Show moreThis thesis shows the potential utility of imaging biomarkers of the heart, kidneys, and visceral adiposity in the clinical management of cardiorenal syndrome and type 2 diabetes. We explored the methods to quantify visceral fat, and demonstrated the potential clinical implications of a special compartment of visceral fat, renal sinus fat. We summarized the current role of imaging techniques in the clinical management of cardiorenal syndrome, and evaluated the preclinical MRI-derived imaging biomarkers in a group of patients with type 4 cardiorenal syndrome. Our findings could potentially benefit the clinical care for patients with metabolic disorders and/or cardiorenal syndrome. Continuous technical developments in quantitative imaging will increase the potential for applying imaging biomarkers in the management of reno-cardiometabolic diseases, and contribute to achieving the goals of personalized medicine. Show less
Aims We aimed to compare renal sinus fat volume assessed by MRI between patients with type 2 diabetes and healthy volunteers, and investigate the association between renal sinus fat and metabolic... Show moreAims We aimed to compare renal sinus fat volume assessed by MRI between patients with type 2 diabetes and healthy volunteers, and investigate the association between renal sinus fat and metabolic traits.Methods In this cross-sectional study, renal sinus fat and parenchyma volumes measured on abdominal MRI were compared between patients and controls using analysis of covariance. Associations of renal parameters with clinical characteristics were analyzed using linear regression analysis.Results A total of 146 participants were enrolled, consisting of 95 type 2 diabetes patients (57.2 +/- 8.8 years, 49.5% male) and 51 controls (54.0 +/- 9.2 years, 43.1% male). Patients with diabetes demonstrated larger sinus fat volumes (15.4 +/- 7.5 cm(3) vs. 10.3 +/- 7.1 cm(3), p < 0.001) and sinus fat-parenchyma ratio than controls. In the total population, renal sinus fat was positively associated with HbA1c, abdominal VAT, cholesterol and triglycerides, after adjustment for age, sex, ethnicity and type 2 diabetes. In type 2 diabetes patients, increased sinus fat volume was significantly associated with urinary albumin-to-creatinine ratio.Conclusion Renal sinus fat volume is positively associated with several metabolic risk factors including HbA1c level and urinary albumin-to-creatinine ratio in type 2 diabetes patients, indicating a potential role of renal sinus fat in the development of diabetic nephropathy. Future studies are needed to investigate whether sinus fat volume can serve as an early biomarker for diabetic nephropathy. Show less
