Relationship between abdominal fat distribution and diabetic complications in patients with type 2 diabetes mellitus

Objective To investigate the association of abdominal fat distribution with glycolipid metabolism and diabetic complications in patients with T2DM. Methods Totally 357 inpatients with T2DM were collected from the Endocrinology Department of our hospital. All patients received quantitative computed tomography to measure the visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and were divided into three groups depending on the tertile of VAT value: T1 group (VAT<162.0 cm2), T2 group (162.0≤VAT<221.1 cm2), T3 group (VAT≥221.1 cm2). The incidences of diabetic kidney disease, diabetic retinopathy, diabetic peripheral neuropathy, peripheral atherosclerosis, and cardia-cerebrovascular disease were examined in all patients. Results HbA1C level in T1 group was higher than that in T3 group(P<0.05). High density lipoprotein-cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) in T1 group were higher compared with those in T2 and T3 groups (P<0.05). Male proportion, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), 24h urinary albumin, diabetic kidney disease and peripheral atherosclerosis in T2 and T3 groups were higher than those in T1 group (P<0.05). Fasting C- peptide (FCP) and modified homeostasis model assessment for insulin resistance (HOMA-IR) in T3 group were higher than those in T1 and T2 group (P<0.01). VAT and SAT were positively correlated with BMI, FCP, and HOMA-IR (p<0.01). VAT was positively correlated with age, SBP, DBP, TG, 24h urinary albumin, diabetic kidney disease, peripheral atherosclerosis, and cardia-cerebrovascular disease (P<0.05), while inversely correlated with HbA1C, HDL-C, and eGFR (P<0.05). SAT was positively correlated with total cholesterol and low density lipoprotein-cholesterol (P<0.01), while negatively correlated with peripheral atherosclerosis (P<0.01). Multivariate logistic regression analysis showed that VAT was still a risk factor for diabetic kidney disease after adjusted by age, BMI, SBP and fasting plasma glucose(P=0.013). Conclusion VAT and SAT are associated with blood lipids and insulin resistance, while VAT seems to be a risk factor for diabetic kidney disease. Key words: Abdominal fat area; Diabetes mellitus, type 2; Diabetic complications; Quantitative computed tomography