Study On The Correlation Between Visceral Fat Area And Diabetic Peripheral Neuropathy In Patients With Type 2 Diabetes Mellitus

ObjectiveTo investigate the correlation between obesity-related indicators in the body composition of patients with type 2 diabetes mellitus(T2DM),especially the visceral fat area,and diabetic peripheral neuropathy(DPN),and to explore new methods for early detection of DPN high-risk T2DM populations.Methods113 patients with T2DM who were hospitalized in the Endocrinology Department of our hospital from September 2020 to January 2021 were included for the cross-sectional study.The study subjects were divided into two groups according to the DPN diagnostic criteria established by the Chinese Diabetes Society:the type 2 diabetes group with diabetic peripheral neuropathy(DPN group)and the type 2 diabetes group without diabetic peripheral neuropathy(NDPN group).Bioelectrical impedance analysis(BIA)was used to measure the obesity data in the body composition of the study subjects including body weight,waist circumference,body mass index,body fat mass,body fat percentage,and visceral fat area by the In Body S10 body composition analyzer.Meanwhile,the height of the study subject was measured,and biochemical indicators and other clinical data were collected.Statistical analysis was performed using SPSS 26.0.ResultIn terms of body composition,the comparisons of height,weight,waist circumference,and visceral fat area between the DPN group and the NDPN group in T2DM patients were as follows:167.50(161.75,174.00)cm vs 161.00(155.00,170.00)cm,P=0.008;70.26±12.40kg vs 64.52±11.53kg,P=0.012;89.20±11.69cm vs 84.31±9.46cm,P=0.015;95.10(65.03,134.05)cm~2vs 82.80(64.40,99.80)cm~2,P=0.048.The differences were statistically significant.There was no statistically significant difference in body mass index,body fat mass,and body fat percentage between the DPN group and the NDPN group in T2DM patients.In male T2DM patients,the difference in visceral fat area between the DPN group and the NDPN group was not statistically significant:89.09±35.02cm~2 vs77.85±28.07cm~2,P=0.153;in female T2DM patients,the difference in visceral fat area between the DPN group and the NDPN group was statistically significant:127.33±41.51cm~2 vs 95.24±42.85cm~2,P=0.019.In terms of biochemical indicators and other clinical data,there were statistically significant differences in the duration of diabetes,fasting plasma glucose,glycated hemoglobin A1c,and uric acid between DPN group and NDPN group:114(48,159)months vs 48(6,96)months,P=0.001;8.15(6.33,10.72)mmol/L vs 6.72(6.21,8.06)mmol/L,P=0.034;8.80(6.73,10.70)%vs 7.10(6.30,9.10)%,P=0.023;337.50(270.75,384.25)umol/L vs 300.00(251.00,353.00)umol/L,P=0.039.Among T2DM patients,the prevalence of diabetic retinopathy in the DPN group was higher than that in the NDPN group(P<0.001).Logistic regression analysis was used to evaluate the relationship between DPN and its related influencing factors in T2DM patients.The univariate logistic regression analysis indicated that visceral fat area,the duration of diabetes,fasting plasma glucose,height,weight,waist circumference,and diabetic retinopathy were significant risk factors for T2DM patients with DPN(P<0.05).In the multivariate logistic regression analysis,after adjusting for gender,the duration of diabetes,fasting plasma glucose,glycated hemoglobin A1c,uric acid,height,weight,waist circumference,and diabetic retinopathy,it was suggested that visceral fat area was one of the independent risk factors for T2DM patients with DPN(OR 1.034[95%CI:1.001,1.068],P=0.044).ConclusionVisceral fat area,as an evaluation index for central obesity,especially for visceral fat obesity,is an independent risk factor for DPN in patients with T2DM.