Lower Visceral Fat Area in Patients with Type 2 Diabetic Peripheral Neuropathy

Abstract

There is preliminary evidence that visceral fat area (VFA) was associated with the presence of type 2 diabetic peripheral neuropathy (DPN) in the Korean population; however, no studies have reported the association in Chinese population. The purpose of this study was to explore the possible correlation of VFA with DPN in such a population. Methods: A total of 2498 hospitalized patients with type 2 diabetes mellitus (T2DM) undergone VFA measurement, and were divided into DPN group (n=900) and non-DPN group (n=1594). The association of VFA with the presence of DPN was evaluated by correlation and multiple logistic regression analyses, generalized additive model with a smooth curve fitting, and receiver operating characteristic (ROC) curve analysis. Results:The VFA was significantly lower in the DPN group than in the non-DPN group (P < 0.001). VFA was significantly and positively associated with sural nerve conduction velocity (SNCV) and amplitude potential (SNAP) and negatively associated with the presence of DPN (all P< 0.001); there was no significant difference in the curve fitting (P = 0.344). Multivariate logistic regression analysis showed that the risk of presence of DPN decreased progressively across the VFA quartiles (P for trend < 0.001) and was significantly lower in patients in the highest VFA quartile than in those in the lowest quartile (OR: 0.382, 95% CI 0.151-0.968, P< 0.001) after multivariate adjustment. The ROC analysis revealed that the best cut-off value of VFA for predicting the presence of DPN was 50.5cm 2 (sensitivity 84.40%; specificity 34.00%). Conclusion: These results suggest that lower VFA level may be associated with increased risk of the presence of DPN in T2DM patients.

Association of Circulating Carbohydrate Antigen 19-9 Level with Type 2 Diabetic Kidney Disease in Chinese Adults: A Cross-Sectional Study

“…Subjects were diagnosed with T2DM according to the 1999 World Health Organization criteria. 25 Inclusion criterion of the participants was adult patients with T2DM aged between 18 and 86 years, who signed an informed consent form. The exclusion criteria were as follows: 1) T1DM, recent acute complications of diabetes, severe diabetic foot ulcers, previous amputation, endocrine diseases other than T2DM; 2) pancreatic cancer, acute and chronic pancreatitis, cancers of the gastrointestinal tract, hepatocellular cancer, cholangitis, cholestasis, obstructive jaundice, liver abscess, liver cirrhosis, and other hepatobiliary, pancreatic and gastrointestinal diseases, and so on; 3) non-diabetic kidney disease, hepatic dysfunction, severe renal failure; 4) acute stroke and coronary syndromes, heart failure, pulmonary disease, hematological diseases, thromboembolic disease; 5) ovarian cancer, endometriosis; 6) connective tissue disorders, autoimmune diseases, inflammatory diseases, infectious disease, presence of stressful conditions (recent surgery, trauma); 7) current pregnancy and lactation; 8) history of abundant alcohol intake; 9) administration of immunosuppressive drug, hormonal replacement therapy, systemic corticosteroids; 10) missing data for serum CA 19-9 and other demographic or clinical characteristic indicators; 13) serum CA 19-9 >37 U/mL.…”

“… 26 Seated systolic and diastolic blood pressures (SBP and DBP) were measured three times by a well-trained nurse following a standard protocol using a mercury sphygmomanometer after the patients had rested quietly for 5–10 minutes, and the average of the three measurements was used for analysis. 25 …”

“…Atherogenic indices (atherogenic coefficient [AC], atherogenic index of plasma [AIP]) were calculated using lipid parameters. 25 The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate the estimated glomerular filtration rate (eGFR). 25 , 27 The urine samples were collected the following morning to measure the urinary microalbumin using immunoturbidimetric tests and creatinine enzymatically, and albumin-to-createinine ratio (UACR; mg/g creatinine) was calculated.…”

“… 25 The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to calculate the estimated glomerular filtration rate (eGFR). 25 , 27 The urine samples were collected the following morning to measure the urinary microalbumin using immunoturbidimetric tests and creatinine enzymatically, and albumin-to-createinine ratio (UACR; mg/g creatinine) was calculated. 26 , 28 DKD was diagnosed through low eGFR (eGFR <60 mL/min/1.73 m 2 ), albuminuria (UACR ≥30 mg/g), or both.…”

“… 26 , 28 DKD was diagnosed through low eGFR (eGFR <60 mL/min/1.73 m 2 ), albuminuria (UACR ≥30 mg/g), or both. 25 , 27 , 28 …”