prefinal OSCE
Since your body can only store required glycogen, if you eat a lot of sugar more than your muscles and liver can hold at one time—your body needs another place to put the excess. In that case, it converts that extra glucose into fat through a chemical process called lipogenesis. This fat is stored under the skin (subcutaneous fat), around your abdominal organs (visceral fat), or in certain other organs such as your liver. If glycogen is like a checking account, then fat is your body’s savings account. It hangs onto this fat in case you use up your glycogen stores.
Sugar isn’t the only compound your body can turn into fat. If you eat too much protein, the extra protein gets stored as fat, too. Like sugar, protein contains calories, so if you take in more calories than you burn, the excess protein is converted first into glycogen and then into fat. Still, you’re more likely to store sugar as fat than protein.
Increased visceral fat accumulation causes adipose tissue inflammation and adipokine dysregulation , which can lead to dyslipidemia, insulin resistance, renin-angiotensin-aldosterone system (RAAS) overactivation , sodium retention ,extracellular fluid volume expansion.
Increased visceral fat accumulation is also accompanied with perirenal and renal sinus fat accumulation, which causes high intrarenal pressure, which leads to compression of the vasa recta capillaries and thin loops of Henle, reduced blood flow in the renal medulla, increased sodium reabsorption in the loop of Henle, RAAS activation, and increased sodium reabsorption
These pathological conditions interact in a complex manner, ultimately damaging the kidneys by causing glomerular hyperfiltration and inflammation both of which are characteristics of obesity-related kidney disease.
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