Endocrinol Metab.  2020 Mar;35(1):122-131. 10.3803/EnM.2020.35.1.122.

Associations of Perirenal Fat Thickness with Renal and Systemic Calcified Atherosclerosis

  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. bokyungkoomd@gmail.com
  • 2Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
  • 3Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.


We investigated associations between perirenal fat thickness and atherosclerotic calcification in six different vascular beds.
Using a community-based cohort (n=3,919), perirenal fat thickness was estimated from computed tomography scans. It was classified as Q1 (the lowest quartile) to Q4 (the highest quartile) in each sex. Calcification in the carotid arteries, coronary arteries, thoracic aorta, abdominal aorta, iliac arteries, and renal arteries was evaluated.
Perirenal fat thickness was associated with older age (P<0.01) and a higher prevalence of obesity, hypertension, and dyslipidemia (P<0.01 for all). Perirenal fat thickness was independently associated with renal arterial calcification even after adjustment for age, sex, body mass index, hypertension, dyslipidemia, smoking history, and family history of heart diseases in first-degree relatives (odds ratio [OR] per quartile of perirenal fat thickness, 1.25; 95% confidence interval [CI], 1.09 to 1.44). Compared to Q1, the odds of renal arterial calcification in Q4 was about two times higher (OR, 2.05; 95% CI, 1.29 to 3.25). After adjustment for renal arterial calcification and atherosclerotic risk factors, the only other vascular bed where perirenal fat thickness showed a significant association with calcification was the abdominal aorta (OR, 1.11; 95% CI, 1.00 to 1.23; P=0.045).
Perirenal fat thickness was independently associated with vascular calcification in the renal artery and abdominal aorta.


Atherosclerosis; Vascular calcification; Obesity; Renal artery; Aorta, abdominal

MeSH Terms

Aorta, Abdominal
Aorta, Thoracic
Body Mass Index
Carotid Arteries
Cohort Studies
Coronary Vessels
Heart Diseases
Iliac Artery
Renal Artery
Risk Factors
Vascular Calcification


  • Fig. 1 The risk of arterial calcification according to the quartiles of perirenal fat thickness. Total perirenal fat thickness was defined as the sum of perirenal fat thickness of both sides, and it was classified as Q1 (the lowest quartile) to Q4 (the highest quartile). Odds ratios (ORs) with 95% confidence interval (CIs) of the calcification in each arterial bed according to the perirenal fat thickness are shown (A) in the entire population, (B) those without renal artery calcification, and (C) in those with renal artery calcification. All statistical values were adjusted for age, sex, body mass index, hypertension, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, smoking history, and family history of heart disease in first-degree relatives. RACS, renal artery calcification score. aP<0.05 compared to Q1; bP<0.005 compared to Q1; cP for trend.


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