Correlation of visceral fat area and sarcopenia in patient with type 2 diabetes / 解放军医学杂志

ABSTRACT

Objective To investigate the correlation of visceral fat area (VFA) and sarcopenia in patients with type 2 diabetes mellitus (T2DM). Methods A total of 291 T2DM patients were selected including 202 males and 89 females with average age of (56.9±10.3) years, admitted in the Department of Endocrinology in the First Affiliated Hospital of Chongqing Medical University from Jan. 2016 to Dec. 2018. The clinical data of subjects were collected including their age, course of disease, body mass index (BMI), glycated hemoglobin (HbA1c), complications, comorbidity and medication situation, et al. Then the HOMA-2 calculator was used to work out the HOMA2-IR. Body composition was measured by using dual energy X-ray absorptiometry (DEXA). Depending on whether or not they have sarcopenia, patients were divided into groups for a comparative statistical analysis, the multivariate logistic regression model was used to analyze the influencing factors of sarcopenia, and the matrix distribution scatter plot was drawn to analyze the relationship between related indicators and sarcopenia. According to the China reference standard, the BMI was then grouped and each group will be analyzed again with the above-mentioned multivariate logistic regression model. Lastly, the receiver operating characteristic (ROC) curve was adopted to analyze the predictive value of VFA for sarcopenia. Results According to the presence or absence of sarcopenia, 291 patients were divided into two groups non-sarcopenia group (n=233) and sarcopenia group (n=58). The levels of BMI, systolic blood pressure, diastolic blood pressure, TG, VFA and appendicular skeletal muscle index (ASMI) were lower, while the proportion of smokers was higher in sarcopenia group than that in non-sarcopenia group with statistically significant difference (P<0.05). Male, low BMI and high VFA were the risk factors for sarcopenia (P<0.05); the area under the ROC curve (AUC) for jointly predicting sarcopenia with gender, BMI and VFA was 0.893. When 18.5 kg/m2≤ BMI<24 kg/m2, no remarkable correlation existed between sarcopenia and VFA, but positive correlation appeared after correction of gender and BMI (OR=1.027, P=0.005); the AUC for jointly predicting sarcopenia with gender, BMI and VFA was 0.849. When 24 kg/m2≤BMI<28 kg/m2, VFA was positively correlated with sarcopenia (P=0.001), and after correction of gender and BMI, such a correlation remained (OR=1.053, P=0.001); and the AUC for jointly predicting sarcopenia with gender, BMI and VFA was 0.940. Conclusions The visceral obesity is a risk factor for sarcopenia in patient with T2DM. The combined examination of gender, BMI and VFA has a relatively high value for predicting sarcopenia, and therefor is worthy of clinical reference.