Visceral fat area and diabetic peripheral neuropathy in patients with type 2 diabetes / 中华内分泌代谢杂志

ABSTRACT

Objective:To assess the relationship between visceral fat area(VFA) and diabetic peripheral neuropathy (DPN) in type 2 diabets mellitues(T2DM) patients.Methods:A total of 2 615 patients with T2DM were enrolled from the National Metabolic Management Center at Ningbo First Hospital between March 2018 and February 2021. The medical history, questionnaire survey, and laboratory parameters were collected, VFA was measured using bioelectrical impedance analysis, DPN was diagnosed based on neurophysiological examination. Patients were divided into four groups by VFA and body mass index as the following VFA<100 cm 2 and body mass index<24 kg/m 2 group [VA(-)OB(-) group], VFA<100 cm 2 and body mass index≥24 kg/m 2 group [VA(-)OB(+ ) group], VFA≥100 cm 2 and body mass index<24 kg/m 2 group [VA(+ )OB(-) group], and VFA≥100 cm 2 and body mass index≥24 kg/m 2 group [VA(+ )OB(+ ) group]. Multivariable logistic regression analysis was done to determine the relationship between body mass index, VFA and DPN in patients with T2DM. Results:The proportion of DPN in this study was 46.96%. DPN group featured with older age, higher proportion of men, longer duration of disease, higher proportion of smoking, lower diastolic blood pressure, higher HbA 1C level, lower total cholesterol, lower high density lipoprotein-cholesterol, lower low density lipoprotein-cholesterol, higher blood creatinine levels, higher urinary albumin-to-creatinine ratio, higher VFA level (all P<0.01). Grouping according to VFA and body mass index, 68.1% in the VA(+ )OB(-) group had DPN, which was highest among the four groups. In multivariable logistic regression analysis, compared with VA(-)OB(-) group, VA(+ )OB(-) group had a significantly higher risk of DPN ( OR=2.234, 95% CI 1.339-3.728, P =0.002), VA(+ )OB(+ ) group took second place ( OR=1.281, 95% CI 1.030-1.592, P =0.026). Conclusions:VFA was associated with DPN in T2DM regardless of body mass index. The VA(+ )OB(-) group has the highest risk of DPN. Therefore, evaluation of visceral adiposity may have important clinical significance for the early screening and prevention of DPN in T2DM.