Lower Visceral Fat Area in Patients with Type 2 Diabetic Peripheral Neuropathy

Author(s): Yuru Wu ¹ ^, ² ^, ³ ^, ⁴ , Qin Wan ¹ ^, ² ^, ³ ^, ⁴ , Yong Xu ¹ ^, ² ^, ³ ^, ⁴ , Jia Li ¹ ^, ² ^, ³ ^, ⁴ , Ke Li ¹ ^, ² ^, ³ ^, ⁴ , Zhihong Zhang ⁵ , Qian Tang ¹ ^, ² ^, ³ ^, ⁴ , Ying Miao ¹ ^, ² ^, ³ ^, ⁴ , Pijun Yan ¹ ^, ² ^, ³ ^, ⁴

Publication date (Electronic): 21 November 2022

Journal: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy

Publisher: Dove

Keywords: visceral fat area, diabetic peripheral neuropathy, sural nerve conduction velocity, sural nerve amplitude potential, Chinese population

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Abstract

Objective

There is preliminary evidence that visceral fat area (VFA) was associated with the presence of type 2 diabetic peripheral neuropathy (DPN) in the Korean population; however, no studies have reported the association in Chinese population. The purpose of this study was to explore the possible correlation of VFA with DPN in such a population.

Methods

A total of 2498 hospitalized patients with type 2 diabetes mellitus (T2DM) undergone VFA measurement, and were divided into DPN group (n=900) and non-DPN group (n=1594). The association of VFA with the presence of DPN was evaluated by correlation and multiple logistic regression analyses, generalized additive model with a smooth curve fitting, and receiver operating characteristic (ROC) curve analysis.

Results

The VFA was significantly lower in the DPN group than in the non-DPN group (P < 0.001). VFA was significantly and positively associated with sural nerve conduction velocity (SNCV) and amplitude potential (SNAP) and negatively associated with the presence of DPN (all P< 0.001); there was no significant difference in the curve fitting (P = 0.344). Multivariate logistic regression analysis showed that the risk of presence of DPN decreased progressively across the VFA quartiles (P for trend < 0.001) and was significantly lower in patients in the highest VFA quartile than in those in the lowest quartile (OR: 0.382, 95% CI 0.151–0.968, P< 0.001) after multivariate adjustment. The ROC analysis revealed that the best cut-off value of VFA for predicting the presence of DPN was 50.5cm ² (sensitivity 84.40%; specificity 34.00%).

Conclusion

These results suggest that lower VFA level may be associated with increased risk of the presence of DPN in T2DM patients.

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Most cited references 67

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Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.

K.G.M.M. Alberti, P.Z. Zimmet (1998)

The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to > or =7.0 mmol l(-1) (6.1 mmol l(-1)). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma > or =6.1 to or =5.6 to <6.1 mmol l(-1)). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.

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Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study.

Caroline S. Fox, Joseph Massaro, Udo Hoffmann … (2007)

Visceral adipose tissue (VAT) compartments may confer increased metabolic risk. The incremental utility of measuring both visceral and subcutaneous abdominal adipose tissue (SAT) in association with metabolic risk factors and underlying heritability has not been well described in a population-based setting. Participants (n=3001) were drawn from the Framingham Heart Study (48% women; mean age, 50 years), were free of clinical cardiovascular disease, and underwent multidetector computed tomography assessment of SAT and VAT volumes between 2002 and 2005. Metabolic risk factors were examined in relation to increments of SAT and VAT after multivariable adjustment. Heritability was calculated using variance-components analysis. Among both women and men, SAT and VAT were significantly associated with blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol and with increased odds of hypertension, impaired fasting glucose, diabetes mellitus, and metabolic syndrome (P range < 0.01). In women, relations between VAT and risk factors were consistently stronger than in men. However, VAT was more strongly correlated with most metabolic risk factors than was SAT. For example, among women and men, both SAT and VAT were associated with increased odds of metabolic syndrome. In women, the odds ratio (OR) of metabolic syndrome per 1-standard deviation increase in VAT (OR, 4.7) was stronger than that for SAT (OR, 3.0; P for difference between SAT and VAT < 0.0001); similar differences were noted for men (OR for VAT, 4.2; OR for SAT, 2.5). Furthermore, VAT but not SAT contributed significantly to risk factor variation after adjustment for body mass index and waist circumference (P < or = 0.01). Among overweight and obese individuals, the prevalence of hypertension, impaired fasting glucose, and metabolic syndrome increased linearly and significantly across increasing VAT quartiles. Heritability values for SAT and VAT were 57% and 36%, respectively. Although both SAT and VAT are correlated with metabolic risk factors, VAT remains more strongly associated with an adverse metabolic risk profile even after accounting for standard anthropometric indexes. Our findings are consistent with the hypothesized role of visceral fat as a unique, pathogenic fat depot. Measurement of VAT may provide a more complete understanding of metabolic risk associated with variation in fat distribution.

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Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables

Ulf Malmqvist, Leif Groop, Anders Rosengren … (2018)

Diabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.

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Author and article information

Journal

Journal ID (nlm-ta): Diabetes Metab Syndr Obes

Journal ID (iso-abbrev): Diabetes Metab Syndr Obes

Journal ID (publisher-id): dmso

Title: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy

Publisher: Dove

ISSN (Electronic): 1178-7007

Publication date (Electronic): 21 November 2022

Publication date Collection: 2022

Volume: 15

Pages: 3639-3654

Affiliations

[1 ]Department of Endocrinology, the Affiliated Hospital of Southwest Medical University , Luzhou, Sichuan, People’s Republic of China

[2 ]Metabolic Vascular Disease Key Laboratory of Sichuan Province , Luzhou, Sichuan, People’s Republic of China

[3 ]Sichuan Clinical Research Center for Nephropathy , Luzhou, Sichuan, People’s Republic of China

[4 ]Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou , Luzhou, People’s Republic of China

[5 ]Department of General Medicine, the Affiliated Hospital of Southwest Medical University , Luzhou, Sichuan, People’s Republic of China

Author notes

Correspondence: Pijun Yan, Department of Endocrinology, The Affiliated Hospital of Southwest Medical University , Luzhou, Sichuan, 646000, People’s Republic of China, Tel/Fax +86-830-3165361, Email peter2007110361@126.com

Author information

Yuru Wu http://orcid.org/0000-0003-4432-2338

Qin Wan http://orcid.org/0000-0002-3498-0399

Pijun Yan http://orcid.org/0000-0001-6692-2401

Article

Publisher ID: 388330

DOI: 10.2147/DMSO.S388330

PMC ID: 9694982

PubMed ID: 36439295

SO-VID: 9d6bf594-49ed-4835-ab91-ff54991dcb56

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 03 September 2022

Date accepted : 10 November 2022

Page count

Figures: 4, Tables: 4, References: 67, Pages: 16

Funding

Funded by: Ministry Science and Technology of China;

Funded by: Luzhou Science and Technology Bureau;

Funded by: Health Commission of Luzhou City;

This study is supported by the grants from the Ministry Science and Technology of China (2016YFC0901200, 2016YFC0901205), research grants from Luzhou Science and Technology Bureau [2013-S-48 (22/30))] and Health Commission of Luzhou City (18173).

Lower Visceral Fat Area in Patients with Type 2 Diabetic Peripheral Neuropathy

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Most cited references 67

Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.

Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study.

Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables

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