398-P: Renal Intraparenchymal Fat Is Linked to Renal Function Decline in People with Diabetes

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Introduction and Objective: People with diabetes have an increased risk to develop chronic kidney disease (CKD). How the ectopic accumulation of lipids in the renal compartments is related to nephropathy is not yet clear. In this study, we investigated the relationship of renal intra-parenchymal fat (RIPF) and kidney function as assessed from glomerular filtration rate (eGFR). Methods: Participants (n=221) from the German Diabetes Study (GDS), including people with type 1 (n=66), type 2 diabetes (n=55) and participants with normoglycemia (n=26) were retrospectively assessed for RIPF content by abdominal chemical-shift-encoded magnetic resonance imaging (MRI) and the water- and fat-reconstructed images were used to calculate fat fraction maps. The association of fat fraction with renal function was tested by multiple linear regression (n=145), adjusting for sex, age, body mass index (BMI), mean arterial pressure (MAP) and subcutaneous (SAT) and visceral adipose tissue (VAT) volumes. Further, the association of the fat fraction with the eGFR slope over follow-up (7.0±4.0 years) was tested (n=121). Results: An increase of 1% in MRI-based fat fraction was inversely associated with a 3.95±1.21 ml/min/1.73 m2 lower eGFR, independently of sex, age, BMI, MAP, VAT and SAT. Further, RIPF content was associated with a faster decline of eGFR (β=-0.57, *p=0.001) over a mean follow-up duration of 7.5 years, independent from all the included confounders. Conclusion: Renal intra-parenchymal fat is linked to lower eGFR and its decline, highlighting its potential as a biomarker for CKD in diabetes. Further studies are required to determine whether RIPF plays a causal role in diabetic nephropathy. Disclosure F.C. Michelotti: None. C. Möser: None. R. Koshiba: None. K.S. Massold: Stock/Shareholder; Dexcom, Inc., Sernova, Corp. O.P. Zaharia: None. M. Schön: None. K. Prystupa: None. K. Bódis: None. S. Trenkamp: None. Y. Kupriyanova: None. J. Meister: None. K. Jandeleit-Dahm: None. M. Roden: Research Support; Boehringer-Ingelheim. Advisory Panel; Echosens. Speaker's Bureau; Madrigal Pharmaceuticals, Inc. Advisory Panel; MSD Life Science Foundation. Board Member; Novo Nordisk. Advisory Panel; TARGET PharmaSolutions, Inc. V. Schrauwen-Hinderling: None. R. Wagner: Speaker's Bureau; Boehringer-Ingelheim, Novo Nordisk. Advisory Panel; Sanofi. Speaker's Bureau; Sanofi. Advisory Panel; Lilly Diabetes.

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