Multiscale Imaging of Human Adipose Tissue: A Neglected Partner in Proteinuria Linked to Obesity

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Nephrotic syndrome (NS) is a systemic disorder characterized not only by glomerular dysfunction but also by profound dysregulation of lipid metabolism and microvascular integrity. Adipose tissue, as a central lipid-handling and endocrine organ, undergoes structural and functional remodeling in chronic renal conditions yet remains underexplored in this context. The aim of this manuscript is to integrate adipose tissue imaging into the diagnostic and mechanistic framework of NS. To establish this perspective, we first summarize current knowledge on adipose tissue architecture and imaging in both physiological states and renal disease. We then present a multimodal imaging approach-combining ultrasound (US), histology, and atomic force microscopy (AFM)-applied to human adipose tissue as a potential diagnostic and pathophysiological marker in NS. Original imaging from our laboratory experience is presented as a demonstrative material, complemented by literature synthesis. Given that different modalities of imaging-based characterization of adipose tissue are sparse across the literature, this pictorial review offers a guide to identifying structural biomarkers of adipose remodeling in NS. By bridging imaging modalities with metabolic and vascular perturbations observed in NS, this work aims to guide future research toward the clinical application of adipose tissue imaging in renal d

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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