# Waist-to-height ratio as a non-invasive marker of renal sinus fat: a MRI-based cohort study

## TL;DR

This study finds that waist-to-height ratio is a better predictor of kidney fat than BMI, which could help assess kidney health in people with obesity.

## Contribution

The study demonstrates that WHtR is a novel and independent predictor of renal sinus fat percentage compared to traditional measures like BMI.

## Key findings

- Waist-to-height ratio (WHtR) is significantly associated with renal sinus fat percentage (RSF%) independent of BMI.
- RSF% is independently correlated with estimated glomerular filtration rate (eGFR) after adjusting for other factors.
- Changes in RSF after bariatric surgery correlate with changes in WHtR and Body Roundness Index (BRI).

## Abstract

Renal sinus fat (RSF) is an ectopic fat depot whose expansion has been linked to hypertension and chronic kidney disease. We assessed a range of adiposity indices to determine whether they offer more accurate predictions of RSF than BMI.

Renal sinus fat (RSF) and RSF relative to total kidney area (RSF%) were assessed via MRI in 74 individuals with severe obesity and 47 lean volunteers. 50 persons with obesity were re-evaluated 6 to 12 months after undergoing bariatric surgery. In multivariable regression analyses adjusted for age, sex, and BMI, the Body Roundness Index (BRI), waist-to-height ratio (WHtR), and waist circumference showed the strongest associations with RSF. Of these, only WHtR was significantly associated with RSF%. In univariate analyses, both RSF and RSF% were inversely correlated with estimated glomerular filtration rate (eGFR); however, in multivariate analysis, only RSF% remained independently associated with eGFR. Post-bariatric surgery, RSF change correlated with changes in WHtR and BRI.

Adiposity measures incorporating waist circumference are associated with RSF independent of BMI. While RSF exhibits a stronger relationship with adiposity measures, RSF% predicts eGFR. Both metrics offer complementary insights and should be considered in future studies.