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Background  Renal sinus fat (RSF) has been recognized as a risk factor for arterial hypertension. This study was addressed to examine whether also para- and perirenal fat accumulation is associated to higher 24-h mean systolic (SBP) and/or diastolic blood pressure (DBP) levels in overweight and obese subjects.    Methods  A cohort of 42 overweight and obese patients, 29 women and 13 men, aged 25–55 years, not treated with any kind of drug, was examined. Body mass index (BMI), waist circumference (WC), fasting insulin and glucose serum levels, insulin resistance (assessed by using the homeostasis model assessment [HOMA IR ]), and 24-h aldosterone urine levels were measured. Ambulatory blood pressure monitoring (ABPM) was measured with 15 min intervals from 7.0 a.m. to 11.0 a.m. and with 30 min intervals from 23.0 to 7.0 for consecutive 24 h, starting from 8:30 AM. Measurement of para- and perirenal fat thickness was performed by ultrasounds by a duplex Doppler apparatus.    Results  Para- and perirenal ultrasonographic fat thickness (PUFT) was significantly and positively correlated with WC ( p  < 0.01), insulin ( p  < 0.01), HOMA IR  ( p  < 0.01), and 24-h mean DBP levels ( p  < 0.05). 24-h mean DBP was also significantly and positively correlated with 24-h aldosterone urine concentrations ( p  < 0.001). A multivariate analysis by multiple linear regression was performed; the final model showed that the association of 24-h mean DBP as dependent variable with PUFT (multiple  R  = 0.34;  p  = 0.026) and daily aldosterone production (multiple  R  = 0.59;  p  = 0.001) was independent of other anthropometric, hormone and metabolic parameters.    Discussion and Conclusions  This study shows a positive independent association between PUFT and mean 24-h diastolic blood pressure levels in overweight and obese subjects, suggesting a possible direct role of PUFT in increasing daily diastolic blood pressure.

Para- and perirenal ultrasonographic fat thickness is associated with 24-hours mean diastolic blood pressure levels in overweight and obese subjects