Impact of increased visceral adiposity with normal weight on the progression of arterial stiffness in Japanese patients with type 2 diabetes

Ryotaro Bouchi; Isao Minami; Norihiko Ohara; Yujiro Nakano; Rie Nishitani; Masanori Murakami; Takato Takeuchi; Momoko Akihisa; Tatsuya Fukuda; Masamichi Fujita; Takanobu Yoshimoto; Yoshihiro Ogawa

doi:10.1136/bmjdrc-2015-000081

Impact of increased visceral adiposity with normal weight on the progression of arterial stiffness in Japanese patients with type 2 diabetes

BMJ Open Diabetes Res Care. 2015 Mar 10;3(1):e000081. doi: 10.1136/bmjdrc-2015-000081. eCollection 2015.

Affiliations

¹ Department of Molecular Endocrinology and Metabolism , Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan.
² Department of Molecular Endocrinology and Metabolism , Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan ; Japan Science and Technology Agency , CREST , Tokyo , Japan.

Abstract

Objective: Normal-weight abdominal obesity has been reported to be associated with poor mortality. We aimed to investigate the impact of increased visceral adiposity with normal weight (OB(-)VA(+)) on the progression of arterial stiffness in patients with type 2 diabetes.

Methods: This was a cross-sectional study of 414 patients with type 2 diabetes (mean age 64±12 years; 40.3% female). Visceral fat area (VFA, cm(2)) was measured by a dual bioelectrical impedance analyzer. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV, cm/s). Patients were divided into four groups by VFA and body mass index (BMI, kg/m(2)) as the following: BMI<25 kg/m(2) and VFA<100 cm(2) (obesity (OB)(-)visceral adiposity (VA)(-)), BMI≥25 kg/m(2) and VFA<100 cm(2) (OB(+)VA(-)), BMI<25 kg/m(2) and VFA≥100 cm(2) (OB(-)VA(+)), and BMI≥25 kg/m(2) and VFA≥100 cm(2) (OB(+)VA(+)). Multivariate linear regression analysis was done to determine the impact of OB(-)VA(+) on arterial stiffness.

Results: Among the patients, 7.2% were OB(-)VA(+) with higher baPWV levels (1956±444 cm/s) than those with OB(+)VA(-) (1671±416 cm/s, p=0.014), those with OB(+)VA(+) (1744±317 cm/s, p=0.048), and those with OB(-)VA(-) (1620±397 cm/s, p=0.024). In multivariate linear regression analysis, OB(-)VA(+) remained independently associated with baPWV (standardized β 0.184, p=0.001).

Conclusions: This study provides evidence for the burden of arterial stiffness in OB(-)VA(+) patients with type 2 diabetes; therefore, evaluation of visceral adiposity is of clinical relevance for the better management of non-obese individuals as well as obese populations.

Keywords: Atherosclerosis; Body Mass Index; Visceral Obesity.