Correlation Between Body Composition And β-cell Function In Patients With Type 2 Diabetes Mellitus

Objective:To investigate the correlation between body composition andβ-cell function in patients with Type 2 Diabetes Mellitus.Methods:Totally 200 type 2 diabetes mellitus(T2DM)patients(Female 78,Male 122)were enrolled from August 2018 to March 2019 in the endocrinology department of the Zhongda Hospital affiliated to Southeast University.All underwent oral glucose tolerance test(OGTT).Fasting plasma glucose(FPG)and fasting C-peptide(FC-P)were collected to calculate Homeostasis model assessment of insulin resistance(HOMA-IR)andβ-cell function(HOMA-β).The patients were divided into normal group(BMI<24kg/m~2)、Overweight group(24kg/m~2≤BMI≤27kg/m~2)and obesity group(BMI>27kg/m~2).Body composition was measured by using Inbody bioelectrical impedance analyzer in patients with T2DM.Results:1.The body composition andβ-cell function analysis of different genderMen showed higher uric acid(UA),as compared to women(P<0.01).There was no statistically significant difference in other serum marker between men and women.Water(W)、protein(Pro)、inorganic salt(IS)、soft lean mass(SLM)、fat free mass(FFM)、skeletal muscle mass(SMM)、appendage lean mass(ALM)、trunk lean(TL)、waist-to-hip ratio(WHR)and BMI(body mass index)were significantly higher for men than women(P<0.01,P<0.05).The percent body fat(PBF)of women is higher than men.Fat(F)、appendage fat(AF)、trunk fat(TF)、visceral fat area(VFA)、HOMA-IR and HOMA-βshowed no significant difference between men and women.2.The body composition andβ-cell function analysis of different group patientsOverweight group、fat group showed higher UA than normal group(P<0.01).UA showed no significant difference between overweight group and fat group.Fat group had higher triglyceride(TG)、2h postprandial C-peptide(2h C-P)than normal group and overweight group(P<0.01,P<0.05).Normal group and overweight group showed no significant difference of TG and 2h C-P.The level of FC-P of Normal group lower than overweight group and fat group(P<0.01,P<0.05).Fat group had higher FC-P than overweight group(P<0.01).Total cholesterol(TC)、high density lipoprotein(HDL)、low density lipoprotein(LDL)、apolipoprotein A1(APOA1)、apolipoprotein B(Apo B)、glycosylated hemoglobin(Hb A1c)and FPG showed no significant difference between different groups.With the increase of BMI,the index of body composition increased.W、Pro、IS、SLM、FFM、SMM、PBF、AM、TL、AF、TF、WHR、VFA、HOMA-IR and HOMA-βshowed significant difference between three groups(P<0.01,P<0.05).3.Correlation between body composition andβ-cell function with different genderIn male,HOMA-βshowed positive correlations with W、Pro、IS、F、SLM、FFM、SMM、PBF、TL、TF、WHR、FC-P、2h C-P、VFA、BMI、UA、right arm lean(RA-L)、1eft arm lean(LA-L)、right leg lean(RL-L)、1eft leg lean(LL-L)、right arm fat(RA-F)、1eft arm fat(LA-F)、right leg fat(RL-F)and 1eft leg fat(LL-F)whereas it correlated inversely with FPG duration、Hb A1c、LDL、Apo B(P<0.01,P<0.05).Age、TG、TC、HDL and Apo A1 showed no correlation with HOMA-β.In female,HOMA-βshowed positive correlations with FC-P、2h C-P whereas it correlated inversely with FPG、Hb A1c、Apo A1(P<0.01,P<0.05).W、Pro、IS、F、SLM、FFM、SMM、PBF、RA-L、LA-L、RL-L、LL-L、RA-F、LA-L、RL-F、LL-F、TF、TL、WHR、VFA、BMI、duration、age、TG、TC、HDL、LDL、Apo B、UA showed no correlation with HOMA-β.4.Correlation between body composition and HOMA-IR with different genderIn male,HOMA-IR showed positive correlations with W、Pro、IS、F、SLM、FFM、SMM、PBF、RA-L、LA-L、TL、RA-F、LA-F、TF、RL-F、LL-F、WHR、FC-P、2h C-P、FPG、VFA、BMI、TG、UA whereas it correlated inversely with Apo A1 and duration(P<0.01,P<0.05).RL-L、LL-L、age、Hb A1c、TC、HDL、LDL and Apo B showed no correlation with HOMA-IR.In female,HOMA-IR showed positive correlations with W、Pro、IS、F、SLM、FFM、SMM、RA-L、LA-L、TL、RL-F、LL-F、RA-F、LA-F、TF、RL-F、LL-F、WHR、FC-P、2h C-P、FPG、VFA、BMI、TG、UA whereas it correlated inversely with Hb A1c and Apo A1(P<0.01,P<0.05).PBF、duration、age、TC、HDL、LDL、Apo A1and Apo B showed no correlation with HOMA-IR.5.Multiple linear regressions with body composition and HOMA-β、HOMA-IRFor total patients,HOMA-βserved as the dependent variable while body composition was the independent variable.FC-P、FPG and RL-L entered the regression equation(r=0.902 r~2=0.814).HOMA-IR served as the dependent variable while body composition was the independent variable.FC-P、FPG and PBF entered the regression equation(r=0.984 r~2=0.969).In male,HOMA-βserved as the dependent variable while body composition was the independent variable.FC-P and FPG entered the regression equation(r=0.891 r~2=0.793).HOMA-IR served as the dependent variable while body composition was the independent variable.FC-P、FPG、PBF、TF and RL-F entered the regression equation(r=0.987 r~2=0.974).In female,HOMA-βserved as the dependent variable while body composition was the independent variable.FC-P、FPG、BMI、Pro and SMM entered the regression equation(r=0.948r~2=0.899).HOMA-IR served as the dependent variable while body composition was the independent variable.FC-P、FPG、SMM and RL-FL entered the regression equation(r=0.987r~2=0.973).Conclusion:1、In male,HOMA-βand HOMA-IR showed significant correlations with most body composition.PBF、TF and RL-F are independent factors to HOMA-IR.2、In female,HOMA-IR showed significant correlations with most body composition.BMI、Pro and SMM are independent factors to HOMA-IR.SMM and RL-L are independent factors to HOMA-β.3、With the increase of BMI,HOMA-βand HOMA-IR increased which indicate that T2DM may keep BMI in a reasonable range.4、For T2DM,body composition should be measured as early as possible and regularly,which is of guiding significance for the nutritional evaluation,diagnosis and treatment.