Abdominal adiposity contributes to adverse glycemic control and albuminuria in Chinese type 2 diabetic patients: A cross-sectional study

J Diabetes. 2017 Mar;9(3):285-295. doi: 10.1111/1753-0407.12414. Epub 2016 Jul 20.

Abstract

Background: Abdominal adipose tissue plays an important role in the development of type 2 diabetes. However, few data have suggested its role in the prognosis of diabetes. This study aimed to investigate the association between waist-hip ratio (WHR), glycemic control, and early nephropathy in Chinese type 2 diabetic patients.

Methods: A cross-sectional study was conducted in 1709 previously- and newly-diagnosed diabetic patients nested in a cohort study consisting of 10 375 participants aged ≥40 years in Shanghai, China. General characteristics through questionnaire, anthropometric measures, and biochemical results were recorded. Statistical analysis was performed by SPSS v20.0.

Results: Each quartile increase in WHR was significantly associated with a fasting plasma glucose (FPG) ≥ 126 mg/dl [OR (95% CI):1.18 (1.06-1.30)], an HbA1c ≥ 7.0% [1.21 (1.08-1.35)], and a HOMA-IR ≥ 2.5 [1.30 (1.16-1.46)] after multivariable adjustments. WHR was not associated with a 2h PG ≥ 200mg/dl [1.13 (0.97-1.31)]. The risk for increased albuminuria (UACR ≥10.18mg/g) was also significantly associated with higher WHR after adjustment for HbA1c [1.14 (1.02-1.27)]. However, no significant relationship was seen between WHR and an estimated glomerular filtration rate < 90 ml/min per 1.73 m2 . Interactions of sex, or physical activity with WHR in association with glycemic control and increased albuminuria were found (P values for interaction <0.05).

Conclusions: These data demonstrated an independent role of abdominal adipose tissue in glycemic control and renal complications of type 2 diabetes. Interventions aiming to reduce abdominal adipose tissue may have additional benefits.

Keywords: glycemic control; type 2 diabetes; urinary albumin-to-creatinine ratio; waist-hip ratio; 血糖控制,2型糖尿病,尿白蛋白与肌酐比,腰臀比.

MeSH terms

  • Abdominal Fat / metabolism*
  • Adiposity*
  • Aged
  • Albuminuria / complications
  • Albuminuria / ethnology
  • Albuminuria / metabolism*
  • Asian People
  • Blood Glucose / metabolism*
  • China
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin Resistance
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Waist-Hip Ratio

Substances

  • Blood Glucose
  • Glycated Hemoglobin A