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Diagnostic performance of hypoechoic perinephric fat as a predictor of prediabetes and diabetes

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate prevalence and predictive value of hypoechoic perinephric fat (HPF) in patients with prediabetes and diabetes compared to non-diabetics.

Methods

Of 240 patients with renal ultrasound and hemoglobin A1c (HbA1c) measurements, 114 patients had either prediabetes (HbA1c 5.7–6.4%) or diabetes (HbA1c ≥ 6.5%), and 126 patients did not. Two radiologists (blinded to diagnosis) reviewed images and discrepancies were resolved by a third. Inter-reader agreement was compared using free-marginal kappa and intraclass correlation coefficient. Fisher’s exact test, Mann–Whitney test, multivariable logistic regression, and Spearman’s rank correlation test with two-tailed p < 0.05 were used to determine statistical significance.

Results

HPF was exclusively identified in prediabetic and diabetic patients with a prevalence of 23% (vs 0%; p < 0.001). Identification of HPF had almost perfect inter-reader agreement (k = 0.94) and was statistically significant (p = 0.034) while controlling for body mass index (BMI) and estimated glomerular filtration rate in multivariable analysis. HPF had extremely high specificity and positive predictive value (100% for both) in patients with prediabetes and diabetes although it was not a sensitive finding (23% sensitivity). In patients with prediabetes and diabetes, those with HPF were statistically significantly more likely to have chronic kidney disease (CKD) (p = 0.003). There was no statistically significant difference in BMI, stages of CKD, and types of diabetes.

Conclusion

Hypoechoic perirenal fat has almost perfect inter-reader agreement and is highly specific for and predictive of prediabetes and diabetes. Its presence may also help identify those with chronic kidney disease among prediabetic and diabetic patients.

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Authors and Affiliations

  1. Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, H1307, Stanford, CA, 94305, USA

    Luyao Shen, Justin R. Tse, Lindsey M. Negrete, Andy Shon, Luke Yoon, Tie Liang & Aya Kamaya

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Correspondence to Luyao Shen.

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Aya Kamaya receives book royalties from Elsevier and research grant from Canon, Inc. Justin Tse has a pending grant from Bayer Healthcare. The remaining authors do not have any disclosures.

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Shen, L., Tse, J.R., Negrete, L.M. et al. Diagnostic performance of hypoechoic perinephric fat as a predictor of prediabetes and diabetes. Abdom Radiol 48, 669–679 (2023). https://doi.org/10.1007/s00261-022-03763-3

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