Intra-Abdominal Fat and Elevated Urine Albumin Excretion in Men With Type 1 Diabetes

Sibley, Shalamar D.; Steffes, Michael W.; Brunzell, John D.

doi:10.2337/dc06-2345

Cited by 9 publications

(5 citation statements)

References 26 publications

(22 reference statements)

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“…In addition to the present analysis, a few studies have reported on the association of computed tomography‐based VAT and SAT measurements with albuminuria (19,20,21,22), demonstrating conflicting results. In a small study of women and men free of hypertension and diabetes ( n = 49), urinary albumin excretion was not significantly correlated with VAT or SAT (19), whereas in 64 men with type 1 diabetes from the EDIC study, only VAT, measured on single slice computed tomography scan, was associated with microalbuminuria (21). Among Japanese adults with type 2 diabetes, VAT was associated with microalbuminuria (22) and macroalbuminuria in men (20).…”

Section: Discussionmentioning

confidence: 73%

“…Among Japanese adults with type 2 diabetes, VAT was associated with microalbuminuria (22) and macroalbuminuria in men (20). Differences in the prior literature may be due to different study sample characteristics, such as the use of healthy volunteers (19) vs. patients with type 1 (21) or type 2 (20,22) diabetes. The findings in the present study extend the current literature with its large sample size, inclusion of participants unselected for obesity or diabetes‐related conditions, adjustment for several covariates including blood pressure and diabetes, and by the use of volumetric assessment of VAT and SAT from computed tomography scans, as compared to the area assessment used in the prior analyses.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, VAT is a metabolically active fat depot that may play a role in the development of cardiovascular disease risk factors (13)(14)(15)(16)(17)(18). Abdominal VAT accumulation can be measured using computed tomography, and previous small studies (n = 49-208) using this technique suggest that VAT may be associated with microalbuminuria (19)(20)(21)(22). However, results have been inconsistent, which may be due to differences in study populations.…”

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confidence: 99%

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Association of Subcutaneous and Visceral Adiposity With Albuminuria: The Framingham Heart Study

Foster

Hwang

Massaro

et al. 2011

Obesity

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Microalbuminuria is a common condition associated with increased incidence of cardiovascular events and mortality. Abdominal obesity is associated with microalbuminuria, but studies linking visceral adipose tissue (VAT) and microalbuminuria are limited. Our objective was to determine the associations of albuminuria with VAT and subcutaneous adipose tissue (SAT). We performed a cross‐sectional study in the Framingham Multi‐Detector Computed Tomography (MDCT) cohort (n = 3,099, 48.2% women, mean age 53 years). VAT and SAT volumes were measured using computed tomography. Urinary albumin‐to‐creatinine ratio (UACR) was calculated from spot urine samples. Microalbuminuria was defined as a UACR >25 mg/g in women or >17 mg/g in men. Overall, 7.9% (n = 244) of the sample had microalbuminuria. Among men, VAT (odds ratio (OR) 1.48 per s.d., P < 0.0001) and SAT (OR 1.37 per s.d., P = 0.0002) were associated with microalbuminuria in minimally adjusted models, which remained significant after multivariable adjustment (VAT OR 1.34 per s.d., P = 0.001; SAT OR 1.28 per s.d., P = 0.005). Additionally, when considered jointly, VAT (P = 0.002) but not SAT (P = 0.2) was associated with microalbuminuria. In women, VAT was associated with microalbuminuria after minimal adjustment (OR 1.28, P = 0.01), but not after multivariable adjustment (OR 1.03, P = 0.8). In multivariable models in women, SAT was associated with a decreased odds of having microalbuminuria (OR 0.75 per s.d., P = 0.03). In conclusion, VAT is associated with microalbuminuria in men but not women. Albuminuria may be a manifestation of visceral adiposity.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Association of Subcutaneous and Visceral Adiposity With Albuminuria: The Framingham Heart Study

Foster

Hwang

Massaro

et al. 2011

Obesity

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“…The common cause of death of people with type 1 diabetes is cardiovascular disease, for which dyslipidaemia is a major risk factor and is treatable, with significant LDL-C, cardiovascular event, and mortality reduction with statins [ 37 ]. The substantial numbers with one or more lipid risk factors such as high triglycerides and total cholesterol and low HDL cholesterol levels, combined with the suggestion of blood pressure elevation, raise the possibility that some patients have features of the metabolic syndrome, which is recognised in type 1 diabetes and associated with higher rates of diabetes vascular complications [ 38 , 39 ]. This “double diabetes” may benefit from the addition of metformin to insulin and risk factor control [ 40 ], though clinical trials with vascular end-points are still awaited.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Mortality Rates and Clinical Characteristics of Type 1 Diabetes among Children and Young Adults in Cochabamba, Bolivia

Gomez¹,

Gregory

Nostas³

et al. 2017

Journal of Diabetes Research

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Objectives To determine incidence, mortality, and clinical status of youth with diabetes at the Centro Vivir con Diabetes, Cochabamba, Bolivia, with support from International Diabetes Federation Life for a Child Program. Methods Incidence/mortality data analysis of all cases (<25 year (y)) diagnosed January 2005–February 2017 and cross-sectional data (December 2015). Results Over 12.2 years, 144 cases with type 1 diabetes (T1D) were diagnosed; 43.1% were male. Diagnosis age was 0.3–22.2 y; peak was 11-12 y. 11.1% were <5 y; 29.2%, 5–<10 y; 43.1%, 10–<15 y; 13.2%, 15–<20 y; and 3.5%, 20–<25 y. The youngest is being investigated for monogenic diabetes. Measured incidence in Cercado Province (Cochabamba Department) was 2.2/100,000 children < 15 y/y, with ≈80% ascertainment, giving total incidence of 2.7/100,000 children < 15 y/y. Two had died. Crude mortality rate was 2.3/1000 patient years. Clinical data on 141 cases <35 y: mean/median HbA1c was 8.5/8.2% (69/62 mmol/mol), levels higher in adolescents. Three were on renal replacement therapy; four others had substantial renal impairment. Elevated BMI, triglycerides, and cholesterol were common: 19.1%, 18.3%, and 39.1%, respectively. Conclusions Bolivia has low T1D incidence. Reasonable glycemic control is being achieved despite limited resources; however, some have serious complications and adverse cardiovascular risk factor profiles. Further attention is needed for complications.

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“…Although a few limited number of studies have evaluated the association between visceral adipose tissue and albuminuria[ 16 ], most analyses were conducted among diabetic patients [ 17 , 18 ] and displayed as a cross-sectional design. [ 15 , 16 ] To date, no longitudinal study has examined changes in visceral fat mass (∆VFM) over several years, and the implied health risks such as development of proteinuria.…”

Section: Introductionmentioning

confidence: 99%

Four-Year Changes in Visceral Fat Mass and the Risk of Developing Proteinuria in the General Population

et al. 2015

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BackgroundPrevious cross-sectional studies demonstrated the close relationship between visceral obesity and the increased prevalence of proteinuria. But, little is known about the role of changes in visceral fat mass (∆VFM) over several years in the development of proteinuria. In this longitudinal cohort study with the general population, the changes in ∆VFM as well as baseline VFM on proteinuria development were evaluated.MethodsHealthy individuals (n = 2393) who participated in two health screening exams were analyzed. Subjects were divided into three groups based on gender-specific tertiles of baseline VFM and ∆VFM. Each patient was tested for proteinuria using a dipstick, and proteinuria was defined as 1+ or greater.ResultsThe mean age was 51.9±7.7 years, and the incidence of proteinuria was 3.9% (n = 93). During the 4 years, 52.5% of the subjects experienced a decline in ∆VFM. However, subjects who developed proteinuria exhibited a significant increase in ∆VFM. Even after adjustment for age, smoking, systolic and diastolic BP, serum creatinine, and hs-CRP levels, the highest tertiles for baseline VFM [men, odds ratio (OR) 3.43, 95% confidence interval (CI) 1.22–9.67; women, OR 2.01, 95% CI 1.05–4.15] and ∆VFM (men, OR 2.92, 95% CI 1.22–6.99; women, OR 3.16, 95% CI 1.56–6.39) were independent predictors of proteinuria development. Following adjustment of both parameters, subjects in the highest baseline VFM and ∆VFM tertiles exhibited the greatest risk of proteinuria development, which suggested the additive harmful effects of the two factors.ConclusionsBaseline VFM and greater increase in ∆VFM were both important risk factors for developing proteinuria in the general population. Appropriate education and interventions to prevent accumulation of VFM should be the major focus of preemptive strategies.

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Intra-Abdominal Fat and Elevated Urine Albumin Excretion in Men With Type 1 Diabetes

Cited by 9 publications

References 26 publications

Association of Subcutaneous and Visceral Adiposity With Albuminuria: The Framingham Heart Study

Association of Subcutaneous and Visceral Adiposity With Albuminuria: The Framingham Heart Study

Incidence and Mortality Rates and Clinical Characteristics of Type 1 Diabetes among Children and Young Adults in Cochabamba, Bolivia

Four-Year Changes in Visceral Fat Mass and the Risk of Developing Proteinuria in the General Population

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