Different Indicators of Adiposity and Fat Distribution and Cardiometabolic Risk Factors in Patients with Type 2 Diabetes

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.

Automated summary

This study evaluated the impact of adiposity and fat distribution on cardiovascular risk factors in adults with type 2 diabetes mellitus. It found that increased leg fat mass was associated with better glycemic control, while increased android fat mass was linked to higher risks of hypertension. Increasing BMI, trunk-to-leg fat ratio, and android-to-gynoid fat ratio were all significantly associated with elevated risks of cardiovascular risk factors.