Association Between Abdominal Fat Distribution And Insulin Resistance In Overweight/Obese Type 2 Diabetes Mellitus

Objective:Diabetes mellitus(DM)and overweight/obesity are increasingly threatening human health.The incidence and mortality rates in developed and developing countries are increasing year by year.Type 2 diabetes mellitus(T2DM)with obesity,especially with abdominal obesity(central obesity)and insulin resistance(IR)has become more and more concerned.Related studies have confirmed that insulin resistance caused by accumulation of abdominal fat tissue is one of the key factors for the increase of the incidence of T2DM.This article will analyze the differences in the distribution of abdominal adipose tissue(subcutaneous,visceral)and insulin resistance in overweight/obese T2DM patients,and understand the changes of islet?-cell function in type 2 diabetes with adipose tissue accumulation in different sites.Waist circumference,hip circumference,waist-to-hip ratio,body mass index,blood lipids,islet?-cell function,insulin sensitivity index,insulin resistance index and other indicators were used to analyze the relationship between accumulation of abdominal fat tissue in different parts(subcutaneous and visceral)and insulin resistance.Methods:According to the requirements of the Department of Endocrinology and Inpatient Department of the Sino-Japanese Friendship Hospital of Jilin University from August 2018 to March 2019,the initial diagnosis was 316 cases of T2DM patients,according to body mass index(BMI)and abdominal cavity.The visceral fat area(VA)and subcutaneous fat area(SA)were divided into case control group(BMI<24 kg/m~2,VA<100 cm~2,SA<220 cm~2,102 cases),subcutaneous Fat group(BMI?24 kg/m~2,VA<100 cm~2,SA?220 cm~2,106 cases)and visceral fat group(BMI?24 kg/m~2,VA?100 cm~2,SA<220 cm~2,108 cases).The subjects were recorded for gender,age,duration of diabetes,waist circumference(WC),hip circumference(HC),waist hip ratio(WHR),height,weight,BMI,blood pressure,VA,SA.Fasting plasma glucose(FPG),fasting plasma insulin(INS),triglycerides(TG),total cholesterol(TC),high desity lipoprotein,HDL-C),low desity lipoprotein(LDL-C),calculated islet beta cell function index(HOMA-?),insulin sensitivity index(ISI),Insulin resistance index(HOMA-IR).Comparing the differences between the three groups of general data and clinical indicators,the P value was calculated by one-way ANOVA,P<0.05,indicating statistical difference;and statistical multiple regression analysis was used to compare blood pressure,VA,SA,TG,Correlation between TC,HDL-C,LDL-C and IR.Results:1.One-way analysis of variance showed that there was no significant difference in age,gender and duration between the three groups(P<0.05).There were differences in WC,HC,WHR and BMI between the visceral fat group and the subcutaneous fat group and the case control group.Statistical difference(P<0.05),there was a difference between the visceral fat group and the subcutaneous fat group,but there was no statistical difference(P>0.05);blood pressure,VA,SA,TG,TC,HDL-C,LDL-C among the three groups,HOMA-?,ISI,HOMA-IR were all different,with statistical difference(P<0.05).2.Multiple regression analysis showed that blood pressure,VA,SA,TG,TC,HDL-C,LDL-C were correlated with HOMA-IR,and VA was most significantly correlated with HOMA-IR.Conclusion:1.In overweight/obese T2DM patients,IR is more obvious than normal weight T2DM,and islet?cell function and insulin sensitivity are also significantly reduced.2.The increase of VA and SA is a risk factor for the increase of IR,especially the increase of VA leads to the most significant IR.3.Patients with overweight/obesity T2DM have different levels of dyslipidemia and blood pressure,which is most obvious in patients with increased VA.