1. Normal-weight visceral obesity promotes a higher 10-year atherosclerotic cardiovascular disease risk in patients with type 2 diabetes mellitus–a multicenter study in China.
- Author
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Zheng, Jia, Hu, Ye, Xu, Hanwen, Lei, Yu, Zhang, Jieji, Zheng, Qidong, Li, Li, Tu, Weiping, Chen, Riqiu, Guo, Qiongyao, Zang, Xunxiong, You, Qiaoying, Xu, Zhiyong, Zhou, Qiang, and Wu, Xiaohong
- Subjects
CARDIOVASCULAR diseases ,TYPE 2 diabetes ,HDL cholesterol ,CARDIOVASCULAR diseases risk factors ,LDL cholesterol - Abstract
Background: Visceral obesity is associated with high cardiovascular events risk in type 2 diabetes mellitus (T2DM). Whether normal-weight visceral obesity will pose a higher atherosclerotic cardiovascular disease (ASCVD) risk than body mass index (BMI)-defined overweight or obese counterparts with or without visceral obesity remains unclear. We aimed to explore the relationship between general obesity and visceral obesity and 10-year ASCVD risk in patients with T2DM. Methods: Patients with T2DM (6997) who satisfied the requirements for inclusion were enrolled. Patients were considered to have normal weight when 18.5 kg/m
2 ≤ BMI < 24 kg/m2 ; overweight when 24 kg/m2 ≤ BMI < 28 kg/m2 ; and obesity when BMI ≥ 28 kg/m2 . Visceral obesity was defined as a visceral fat area (VFA) ≥ 100 cm2 . Patients were separated into six groups based on BMI and VFA. The odd ratios (OR) for a high 10-year ASCVD risk for different combinations of BMI and VFA were analysed using stepwise logistic regression. Receiver operating characteristic (ROC) curves for diagnosing the high 10-year ASCVD risk were constructed, and areas under the ROC curves were estimated. Potential non-linear relationships between VFA levels and high 10-year ASCVD risk were examined using restricted cubic splines (knot = 4). Multilinear regression was used to identify factors affecting VFA in patients with T2DM. Results: In patients with T2DM, subjects with normal-weight visceral obesity had the highest 10-year ASCVD risk among the six groups, which had more than a 2-fold or 3-fold higher OR than those who were overweight or obese according to BMI but did not have visceral obesity (all P < 0.05). The VFA threshold for high 10-year ASCVD risk was 90 cm2 . Multilinear regression showed significant differences in the effect of age, hypertension, drinking, fasting serum insulin, fasting plasma glucose, 2 h postprandial C-peptide, triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on VFA in patients with T2DM (all P < 0.05). Conclusions: T2DM patients with normal-weight visceral obesity had a higher 10-year ASCVD risk than BMI-defined overweight or obese counterparts with or without visceral obesity, which should initiate standardised management for ASCVD primary prevention. [ABSTRACT FROM AUTHOR]- Published
- 2023
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