Different Indicators of Adiposity and Fat Distribution and Cardiometabolic Risk Factors in Patients with Type 2 Diabetes
Li Ding, Yuxin Fan, Jing He, Ruodan Wang, Qing He, Jingqiu Cui, Zhongshu Ma, Fangqiu Zheng, Hua Gao, Chenlin Dai, Hongyan Wei, Jun Li, Yuming Cao, Gang Hu, Ming Liu
Abstract
Objective This study aimed to evaluate the effect of adiposity and fat distribution on the odds of elevated cardiovascular risk factors among adults with type 2 diabetes mellitus. Methods The present cross‐sectional study included 2,427 adults with type 2 diabetes mellitus. Body fat was assessed by dual‐energy x‐ray absorptiometry. Multivariate‐adjusted logistic regression was used to estimate effects of adiposity parameters on elevated hemoglobin A 1c (HbA 1c , ≥7.0%), hypertension (blood pressure ≥140/90 mmHg), and elevated low‐density lipoprotein (LDL) cholesterol (≥2.6 mmol/L). Results The multivariable‐adjusted odds ratio (OR) for elevated HbA 1c was 0.82 (95% CI: 0.70‐0.96) for each SD increase in leg fat mass. The multivariable‐adjusted OR for hypertension was 1.15 (95% CI: 1.00‐1.32) for each SD increase in android fat mass. Multivariable‐adjusted ORs for elevated LDL cholesterol ranged from 1.16 (95% CI: 1.00‐1.35) to 1.27 (95% CI: 1.06‐1.51) for each SD increase in arm and android fat mass and percentage of total, truncal, arm, and android fat. Each SD increase in BMI, truncal‐to‐leg fat ratio, and android‐to‐gynoid fat ratio was significantly associated with increased risks of elevated HbA 1c , hypertension, and elevated LDL cholesterol. Conclusions Subcutaneous fat in the lower body was associated with a more favorable glycemic profile, but not blood pressure or lipid profile, whereas central adiposity was associated with poor control of cardiovascular risk factors among patients with type 2 diabetes mellitus.