Body Composition

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

TL;DR

Adiposity measures incorporating waist circumference, particularly waist-to-height ratio, are associated with renal sinus fat independent of BMI, while renal sinus fat relative to total kidney area predicts eGFR.

Key Findings

Body Roundness Index (BRI), waist-to-height ratio (WHtR), and waist circumference showed the strongest associations with RSF in multivariable regression analyses adjusted for age, sex, and BMI.

  • Study included 74 individuals with severe obesity and 47 lean volunteers
  • Renal sinus fat (RSF) and RSF relative to total kidney area (RSF%) were assessed via MRI
  • Multivariable regression analyses were adjusted for age, sex, and BMI
  • Of the three strongest predictors, only WHtR was significantly associated with RSF%

Both RSF and RSF% were inversely correlated with estimated glomerular filtration rate (eGFR) in univariate analyses, but only RSF% remained independently associated with eGFR in multivariate analysis.

  • Univariate analyses showed inverse correlations for both RSF and RSF% with eGFR
  • In multivariate analysis, RSF% but not RSF was independently associated with eGFR
  • This suggests RSF normalized to kidney size is the more relevant predictor of kidney function

Post-bariatric surgery, changes in RSF correlated with changes in WHtR and BRI.

  • 50 persons with obesity were re-evaluated 6 to 12 months after undergoing bariatric surgery
  • RSF change post-surgery correlated with changes in both WHtR and BRI
  • This longitudinal finding supports WHtR and BRI as dynamic markers of RSF change following weight loss intervention

RSF and RSF% offer complementary insights, with RSF showing stronger relationships with adiposity measures and RSF% predicting eGFR.

  • RSF exhibits a stronger relationship with adiposity measures including BRI, WHtR, and waist circumference
  • RSF% is the metric that independently predicts eGFR in multivariate analysis
  • Authors conclude both metrics should be considered in future studies

Adiposity indices incorporating waist circumference are associated with RSF independent of BMI.

  • Associations of BRI, WHtR, and waist circumference with RSF remained significant after adjustment for BMI
  • This suggests these measures capture aspects of fat distribution relevant to RSF beyond overall body mass
  • The study design included a wide range of body sizes by combining 74 individuals with severe obesity and 47 lean volunteers

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Citation

Moriconi D, Honka M, Saukko E, Moritz E, Latva-Rasku A, Dadson P, et al.. (2026). Waist-to-height ratio as a non-invasive marker of renal sinus fat: a MRI-based cohort study.. International journal of obesity (2005). https://doi.org/10.1038/s41366-025-01974-4