Contribution of subcutaneous abdominal fat on ultrasonography to carotid atherosclerosis in patients with type 2 diabetes mellitus

Jung, Chan-Hee; Kim, Bo-Yeon; Kim, Kyu-Jin; Jung, Su Woong; Kim, Chul-Hee; Kang, Suk‐Ku; Mok, Ji‐Oh

doi:10.1186/1475-2840-13-67

Cited by 29 publications

(24 citation statements)

References 41 publications

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“…Furthermore, none of the patients evaluated in our study were obese, and BMI was not associated with CIMT or carotid plaques. These results suggest that the pattern of central fat deposition in type 1 DM may also be associated with increased risk of atherosclerotic CVD and negative metabolic effects, similar to the findings described in type 2 DM patients (8,(22)(23)(24).…”

Section: Resultssupporting

confidence: 76%

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

Kupfer

Larrúbia

Bussade

et al. 2017

Arch. Endocrinol. Metab.

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Objective: This study aimed to evaluate the occurrence and clinical predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. Subjects and methods: The study included 45 women with type 1 diabetes mellitus (DM) (aged 36 ± 9 years) who underwent carotid Doppler ultrasound evaluation to determine the carotid artery intima-media thickness (CIMT) and to assess the occurrence of carotid artery plaques. Insulin sensitivity was assessed by estimated glucose disposal rate (eGDR), and metabolic syndrome (MS) was defined by the World Health Organization criteria. Results: The cohort had a mean age of 36 ± 9 years, diabetes duration of 18.1 ± 9.5 years, and body mass index (BMI) of 24.6 ± 2.4 kg/m 2 . MS was present in 44.4% of the participants. The CIMT was 0.25 ± 0.28 mm, and the prevalence of carotid artery plaques was 13%. CIMT correlated positively with hypertension (p = 0.04) and waist-to-hip ratio (r = 0.37, p = 0.012). The presence of carotid artery plaques correlated positively with age (p = 0.018) and hypertension (p = 0.017). eGDR correlated negatively with CIMT (r = -0.39, p = 0.009) and carotid plaques (p = 0.04). Albuminuria showed a correlation trend with CIMT (p = 0.06). Patients with carotid artery plaques were older, had a higher prevalence of hypertension, and lower eGDR. No correlation was found between CIMT and carotid plaques with diabetes duration, MS, BMI, cholesterol profile, glycated hemoglobin, high-sensitivity C-reactive protein, or fibrinogen. Conclusion: Insulin resistance, central obesity, hypertension, and older age were predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. Arch Endocrinol Metab. 2017;61(2):115-21.

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Section: Resultssupporting

confidence: 76%

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

Kupfer

Larrúbia

Bussade

et al. 2017

Arch. Endocrinol. Metab.

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“…Moreover, the possible protective role of subcutaneous fat against subclinical atherosclerosis, which was not measured in our study, might have affected our results. [27]. Finally, current obesity, rather than its duration, may be the most important precursor of clinical cardiovascular and metabolic outcomes [28].…”

Section: Discussionmentioning

confidence: 99%

Can increased visceral adiposity without body weight changes accelerate carotid atherosclerosis in South Korean participants with type 2 diabetes?

Kim

Araneta

et al. 2015

Journal of Diabetes and its Complications

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Aims: Type 2 diabetes mellitus (T2DM) and visceral obesity are associated with each other and with cardiovascular diseases. We determined whether increased visceral adiposity without weight gain was associated with sex-specific accelerated carotid atherosclerosis in South Koreans with T2DM. Methods: From 2003 to 2012, we recruited 280 participants with T2DM for the Seoul Metabolic Syndrome cohort who had body weight, visceral fat thickness (VFT), and carotid intima-media thickness (CIMT) measured at intervals of 2 years. According to VFT change, sex-specific quartiles of clinical characteristics and changes of CIMT were determined. Logistic regression models predicted the odds of the progression of CIMTs in each quartile. Results: During 2 years of observation, VFTs fell by 5.2±13.5 mm in men (P<0.001) and 3.4±10.5 mm in women (P<0.001). Progression of IMT was only significant for women's maximal IMT (0.031±0.145 mm, P=0.012), while significant improvements in HbA1c were found (0.9%; P<0.001 in both sexes). There were no significant differences in clinical characteristics, or in progression of carotid IMT in men or women according to 2-year quartiles of VFT change. Conclusions: Our results do not suggest that increased visceral adiposity without body weight changes impacts the CIMT progression in South Korean men or women with T2DM. Thank you for the opportunity to revise again, based on the helpful critique of Reviewer 1. Please see our specific responses to reviewers' comments below.Reviewer #1: In this study, they have reported that visceral obesity leads to atherosclerosis. Ultrasonography is a noninvasive, cost-effective method to assess visceral obesity. Visceral fat change without weight change had little effect on atherosclerosis. Despite the advantages, use of sonography for assessment of body composition is accompanied by important disadvantages. Sonography entails use of equipment and is significantly more expensive than simple assessment of anthropometric features. Although the value of sonography has been shown in most studies, sporadic reports question the strong association between sonographic findings and those of standard techniques [1] and clinical outcome [2]. There is also an evident need for objective and accurate indexes such as intraabdominal fat thickness, abdominal wall fat index, preperitoneal fat, minimum subcutaneous fat thickness, mesenteric fat thickness and preperitoneal circumference that can be applied to special patient groups. Furthermore, adequate examiner training is demanded as a precondition for reliable and reproducible measurements. Once these issues are resolved, it is highly plausible that sonography will be used in clinical practice for the routine assessment of regional adiposity. Therefore in my opinion regional adiposity can be assessed with anthropometric data and imaging techniques. The former include waist-to-hip ratio, waist circumference, and abdominal sagittal diameter. A fully automated individualized analyses method is now possible and may, given a...

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“…It was considered that this type of obesity increased the risk of pathological changes in other systems along with the progress of T2DM. [10][11][12] Attention should be paid to the distribution of subcutaneous adipose tissue in patients with T2DM. We found that in patients with T2DM the accumulation of subcutaneous adipose tissue was primarily in torso and less so in the limbs.…”

Section: Discussionmentioning

confidence: 99%

Anthropological Characteristic of the Distribution of Adipose Tissue in Bulgarian Females with Type 2 Diabetes Mellitus

2018

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Background: The complex study of adipose tissue in women with type 2 diabetes mellitus (T2DM) is of importance for the clinical course and prognosis of the disease. Aim: To study the distribution of adipose tissue in Bulgarian females with T2DM. Patients and methods: The study included 92 women with T2DM (age range 40-60 years). The control group consisted of 40 age-matched women. Measurement parameters: height, weight, 9 skinfolds (sf) – sfTriceps, sfBiceps brachii, sfForearm, sfSubscapular, sfXrib, sfAbdomen, sfSuprailiaca, sfThigh, and sfCalf; bioelectrical impedance analysis - % body fat tissue and visceral fat tissue. Calculated indexes: body mass index (BMI), the ratio sfTrunk to sfLimbs, the ratio skin folds upper half of body/skin folds lower half of body, fat mass and subcutaneous fat mass. Results: Statistically significant differences were found in the means of sfTriceps, sfXrib, sfThigh, sfCalf, % body fat tissue, visceral fat tissue, and fat mass and subcutaneous fat mass between the diabetic and healthy women. The body composition of diabetic females aged 40-60 years contained a larger adipose component than controls. Visceral adipose tissue which determines the body composition is a reliable indicator of the health risks in diabetic women. Conclusion: The pattern of subcutaneous adipose tissue distribution in diabetic females aged 40-60 yrs was primarily in the upper torso region and less so in the limbs. In the controls adipose tissue is accumulated primarily in the limbs and in the lower part of the body.

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Contribution of subcutaneous abdominal fat on ultrasonography to carotid atherosclerosis in patients with type 2 diabetes mellitus

Cited by 29 publications

References 41 publications

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

Can increased visceral adiposity without body weight changes accelerate carotid atherosclerosis in South Korean participants with type 2 diabetes?

Anthropological Characteristic of the Distribution of Adipose Tissue in Bulgarian Females with Type 2 Diabetes Mellitus

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