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High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes.

Bouchi R, Takeuchi T, Akihisa M, Ohara N, Nakano Y, Nishitani R, Murakami M, Fukuda T, Fujita M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y - Cardiovasc Diabetol (2015)

Bottom Line: The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups.In multivariate linear regression analysis (Adjusted R(2) = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001).Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Bunkyo-ku, Yushima, Tokyo, 113-8510, Japan. bouchi.mem@tmd.ac.jp.

ABSTRACT

Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis.

Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5% female). Visceral fat area (VFA, cm(2)) and subcutaneous fat area (SFA, cm(2)) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm(2) and VFA < 100 cm(2) [S(-)V(-)], SFA ≥ 100 cm(2) and VFA < 100 cm(2) [S(+)V(-)], SFA < 100 cm(2) and VFA ≥ 100 cm(2) [S(-)V(+)], and SFA ≥ 100 cm(2) and VFA ≥ 100 cm(2) [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses.

Results: Among the patients examined, 16.3% were S(-)V(+). Mean (95 % confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100% male), and S(+)V(-) patients showed female predominance (82% female). In multivariate linear regression analysis (Adjusted R(2) = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model.

Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.

No MeSH data available.


Related in: MedlinePlus

The correlation between visceral fat area and subcutaneous fat area in patients with type 2 diabetes. SFA subcutaneous fat area (cm2), VFA visceral fat area (cm2)
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Fig1: The correlation between visceral fat area and subcutaneous fat area in patients with type 2 diabetes. SFA subcutaneous fat area (cm2), VFA visceral fat area (cm2)

Mentions: A total of 148 Japanese patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 % female) were enrolled in this study. Among the participants, 16.3 % (N = 11) were classified as S(−)V(+), and 23.0 % (N = 34), 26.4 % (N = 39) and 43.2 % (N = 64) were classified as S(−)V(−), S(+)V(−), and S(+)V(+), respectively (Fig. 1). As shown in Table 1, S(−)V(+) patients were older than S(−)V(−) patients (p = 0.004) and S(+)V(+) (p = 0.036), and had a significantly higher VFA-SFA ratio (V/S ratio) than S(−)V(−) (p < 0.001), S(+)V(−) (p < 0.001), and S(+)V(+) patients (p < 0.001). Systolic blood pressure in S(−)V(+) patients were significantly higher than S(−)V(−) (p < 0.001) and S(+)V(−) patients (p < 0.001). Interestingly, there were appreciable differences in gender and fat distribution between S(−)V(+) and S(+)V(−) patients, without a significant difference in BMI. In this study, S(−)V(+) patients were male predominant (100 % male), and S(+)V(−) patients showed female predominance (82 % female). Moreover, S(−)V(+) patients had significantly higher uric acid (p < 0.001) and glutamyl transpeptidase (γ-GTP) (p < 0.001) levels than S(+)V(−) patients. The S(−)V(+) patients had reached the maximum BMI at younger age (43 ± 12 years) than S(+)V(−) patients (47 ± 11 years) and S(+)V(+) patients (51 ± 13 years). The maximum BMI in S(−)V(+) patients was significantly lower than that S(+)V(−) and S(+)V(+) patients (data not shown). Medications were listed in Table 2. None of S(−)V(+) patients received biguanides nor statins, although S(−)V(+) patients showed increased visceral fat accumulation. The number of S(+)V(+) patients taking biguanides and statins was greater than those of S(−)V(−), S(+)V(−), and S(+)V(+) patients.Fig. 1


High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes.

Bouchi R, Takeuchi T, Akihisa M, Ohara N, Nakano Y, Nishitani R, Murakami M, Fukuda T, Fujita M, Minami I, Izumiyama H, Hashimoto K, Yoshimoto T, Ogawa Y - Cardiovasc Diabetol (2015)

The correlation between visceral fat area and subcutaneous fat area in patients with type 2 diabetes. SFA subcutaneous fat area (cm2), VFA visceral fat area (cm2)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4597374&req=5

Fig1: The correlation between visceral fat area and subcutaneous fat area in patients with type 2 diabetes. SFA subcutaneous fat area (cm2), VFA visceral fat area (cm2)
Mentions: A total of 148 Japanese patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 % female) were enrolled in this study. Among the participants, 16.3 % (N = 11) were classified as S(−)V(+), and 23.0 % (N = 34), 26.4 % (N = 39) and 43.2 % (N = 64) were classified as S(−)V(−), S(+)V(−), and S(+)V(+), respectively (Fig. 1). As shown in Table 1, S(−)V(+) patients were older than S(−)V(−) patients (p = 0.004) and S(+)V(+) (p = 0.036), and had a significantly higher VFA-SFA ratio (V/S ratio) than S(−)V(−) (p < 0.001), S(+)V(−) (p < 0.001), and S(+)V(+) patients (p < 0.001). Systolic blood pressure in S(−)V(+) patients were significantly higher than S(−)V(−) (p < 0.001) and S(+)V(−) patients (p < 0.001). Interestingly, there were appreciable differences in gender and fat distribution between S(−)V(+) and S(+)V(−) patients, without a significant difference in BMI. In this study, S(−)V(+) patients were male predominant (100 % male), and S(+)V(−) patients showed female predominance (82 % female). Moreover, S(−)V(+) patients had significantly higher uric acid (p < 0.001) and glutamyl transpeptidase (γ-GTP) (p < 0.001) levels than S(+)V(−) patients. The S(−)V(+) patients had reached the maximum BMI at younger age (43 ± 12 years) than S(+)V(−) patients (47 ± 11 years) and S(+)V(+) patients (51 ± 13 years). The maximum BMI in S(−)V(+) patients was significantly lower than that S(+)V(−) and S(+)V(+) patients (data not shown). Medications were listed in Table 2. None of S(−)V(+) patients received biguanides nor statins, although S(−)V(+) patients showed increased visceral fat accumulation. The number of S(+)V(+) patients taking biguanides and statins was greater than those of S(−)V(−), S(+)V(−), and S(+)V(+) patients.Fig. 1

Bottom Line: The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups.In multivariate linear regression analysis (Adjusted R(2) = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001).Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Bunkyo-ku, Yushima, Tokyo, 113-8510, Japan. bouchi.mem@tmd.ac.jp.

ABSTRACT

Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis.

Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5% female). Visceral fat area (VFA, cm(2)) and subcutaneous fat area (SFA, cm(2)) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm(2) and VFA < 100 cm(2) [S(-)V(-)], SFA ≥ 100 cm(2) and VFA < 100 cm(2) [S(+)V(-)], SFA < 100 cm(2) and VFA ≥ 100 cm(2) [S(-)V(+)], and SFA ≥ 100 cm(2) and VFA ≥ 100 cm(2) [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses.

Results: Among the patients examined, 16.3% were S(-)V(+). Mean (95 % confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100% male), and S(+)V(-) patients showed female predominance (82% female). In multivariate linear regression analysis (Adjusted R(2) = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model.

Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.

No MeSH data available.


Related in: MedlinePlus