Study On The Correlation Between Anthropometric Indicators And Visceral Fat Content And Chronic Complications In Type 2 Diabetic Patients

Objective:To investigating visceral adipose tissue(VAT)deposition and comorbid chronic complications in patients with type 2 diabetes mellitus(T2DM),explored the correlation between waist circumference(WC),waist-to-height ratio(WHt R),body mass index(BMI),visceral adipose index(VAI),body roundness index(BRI),Conicity index(C-index),abdominal volume index(AVI),a body shape index(ABSI),CUN-BAE(Clinica Universidad de Navanra-Body Adiposity Estimator)and lipid accumulation product(LAP)with visceral fat content of patients with T2DM and chronic complications of diabetes.Methods:From July 2020 to December 2022,473 patients with type 2 diabetes who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Nanchang University were collected,and the L2-L3 slice images were extracted from their quantitative CT(QCT)images to calculate total fat area(TFA)and visceral fat area(VFA).According to the VFA measurements.54 patients were divided into T2DM group(VFA<80cm~2)and 419 patients in T2DM with visceral obesity group(VFA≥80cm~2).The general data of gender,age,disease duration,SBP,DBP,height,weight and WC were collected from all patients,and their fasting state glycated hemoglobin(Hb Alc),FPG,FCP,TG,TC,HDL-C,LDL-C,UA and other laboratory data,on the basis of which the corresponding anthropometric indicators,HOMA-IR and HOMA-β,the subjects were assessed for the presence of combined chronic complications.The following four complications were included in this study:DPN、DR、DKD and PAS.The t-test was used for comparison of measurement data,and theX2-test was used for comparison of counting data.Logistic regression was used to analyze the relationship between different anthropometric indicators and chronic complications in patients.Results:(1)The weight,SBP,DBP,TG,UA,FCP,HOMA-IR,VFA,and SFA of T2DM with visceral obesity group were higher(P<0.05)and HDL-C was lower(P<0.01)compared with the T2DM group.Among anthropometric measures,WC,hip circumference,BMI,WHR,WHt R,LAP,VAI,BRI,AVI,ABSI,C-index,CUN-BAE of T2DM with visceral obesity group were higher(P<0.05).(2)Among the glucose metabolism indicators:FPG was positively correlated with LAP,VAI,BRI,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05);FCP was positively correlated with BMI,LAP,VAI,BRI,ABSI,C-index,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05);FINS was positively correlated with BMI,LAP,VAI,BRI,ABSI,C-index,AVI,WHt R,WC,hip circumference and VFA;FINS was positively correlated with BMI,LAP,VAI,BRI,ABSI,C-index,AVI,CUN-BAE,WHt R,WHR,WC,hip circumference and VFA(P<0.05);Hb A1c was positively correlated with LAP,VAI,BRI,ABSI,C-index,AVI,WHt R,WHR and WC(P<0.05);HOMA-IR was positively correlated with BMI,LAP,VAI,BRI,ABSI,C-index,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05);HOMA-βwas positively correlated with BRI,ABSI,C-index,AVI,WHt R,WC and hip circumference(P<0.05).(3)Among the lipid metabolism indexes:TC was positively correlated with BMI,LAP,VAI and CUN-BAE(P<0.05);TG was positively correlated with BMI,LAP,VAI,BRI,CUN-BAE,C-index,AVI,WHt R,WHR,WC,hipcircumferenceand VFA(P<0.05);HDL-C was negatively correlated with BMI,LAP,VAI,BRI,C-index,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05);LDL-C was positively correlated with BMI,LAP and hip circumference(P<0.05).(4)Blood pressure,VFA,UA and other indicators:DBP was positively correlated with BMI,BRI,ABSI,CUN-BAE,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05).SBP was positively correlated with BMI,LAP,BRI,ABSI,C-index,WHt R,WHR,WC,hip circumference and VFA(P<0.05).UA was positively correlated with BMI,LAP,VAI,BRI,ABSI,AVI,WHt R,WHR,WC,hip circumference and VFA(P<0.05)and negatively correlated with C-index(P<0.05).VFA was positively correlated with BMI,LAP,VAI,BRI,CUN-BAE,C-index,AVI,WHt R,WHR,WC,and hip circumference(P<0.05).Among them,AVI,WC,and BMI were better correlated.(5)The results of regression analysis with the presence of retinopathy as the dependent variable showed that VFA,WC,and LAP were independent risk factors for DR.(6)The results of regression analysis with the presence of peripheral neuropathy as the dependent variable showed that VFA was an independent risk factor for DPN.(7)The results of regression analysis with the presence of diabetic nephropathy as the dependent variable showed that DBP,UA,and Hb A1c were independent risk factors for DKD.(8)The results of regression analysis with the presence of peripheral atherosclerosis as the dependent variable showed that hip circumference was a protective factor for PAS.Conclusion:(1)T2DM with visceral obesity are accompanied by more serious disorders of lipid metabolism and glucose metabolism.(2)VFA is positively correlated with most anthropometric indicators,among which AVI,WC and BMI are better correlated and can be used clinically to assess abdominal obesity.(3)WC and LAP are independent risk factors for DR,and hip circumference is a protective factor for PAS.The anthropometric indexes can reflect the visceral fat area and the association with diabetic complications to some extent.