Key result
Visceral fat area was independently associated with left ventricular mass index (β=0.04, p=0.016) and better predicted cardiovascular disease risk (AUC 0.609; 95% CI 0.563-0.656) than subcutaneous fat.
Why the study?
This study was conducted to assess the association between visceral fat area and cardiac hemodynamics in patients with type 2 diabetes mellitus.
Is visceral fat area associated with altered cardiac hemodynamics in patients with type 2 diabetes?
Observational (n=568)
Is visceral fat area associated with altered cardiac hemodynamics in patients with type 2 diabetes?
Effect estimate: β=0.04
p-value: p=0.016
Visceral fat area is significantly associated with adverse cardiac hemodynamics and cardiovascular risk in patients with type 2 diabetes, whereas subcutaneous fat area is not.
Visceral adiposity was associated with cardiac remodeling in T2D; supports further investigation but should not yet alter practice.
Background: This study was conducted in patients with type 2 diabetes mellitus (T2DM) to assess the association between visceral fat area (VFA) and cardiac hemodynamics. Methods: A total of 568 patients with type 2 diabetes (mean age 54± 12 years; 40.8% of women) were enrolled. Visceral fat area (VFA, m 2 ) and subcutaneous fat area (SFA, m 2 ) were evaluated by a bioelectrical impedance analyzer. Cardiac hemodynamics were measured by echocardiography, and other clinical and laboratory variables were also assessed and recorded. Patients were divided into those with VFA ≤ 100 (n=369) and those with VFA > 100 (n=199). Results: VFA, SFA, LVMI (left ventricular mass index), left atrial diameter, left ventricular diastolic diameter (LvDd), interventricular septal thickness (IVST), left ventricular systolic diameter (LvSd), and posterior wall thickness (PWT) levels in high-V groups were significantly higher than those in low-V groups. Correlation analysis showed that VFA was positively correlated with LVMI ( r =0.120, p =0.004), LVM ( r =0.249, p < 0.0001), left atrial diameter ( r =0.375, p < 0.0001), aortic root diameter ( r =0.243, p < 0.0001), left ventricular systolic diameter (LvSd) ( r =0.211, p < 0.0001) and negatively correlated with LVEF ( r =− 0.107, p =0.011). In multivariate linear regression analysis, VFA was the strongest independent determinant of LVMI ( β =0.04, p =0.016), LVEF ( β =− 0.01, p =0.023), and left atrial diameter ( β =0.035, p < 0.0001), Internal diameter of the aortic root ( β =0.014, p < 0.0001) and LvSd ( β =0.017, p < 0.0001). In addition, the VFA also better predicted cardiovascular disease risk with AUC of 0.609 (95% CI:0.563– 0.656), compared with SFA, waist–hip ratio (WHR), in a statistically significant manner. Conclusion: We found a significant correlation between VFA (but not SFA) and cardiac hemodynamic parameters. The VFA has advantages as a predictor of visceral obesity and is significantly associated with the development of cardiovascular risk factors (CVD) in T2DM patients.
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Qiu et al. (2020) conducted an observational in Type 2 diabetes mellitus (n=568). Visceral fat area (VFA) vs. Subcutaneous fat area (SFA) or low VFA (≤100) was evaluated on Left ventricular mass index (LVMI) (β=0.04, p=0.016). Visceral fat area was independently associated with left ventricular mass index (β=0.04, p=0.016) and better predicted cardiovascular disease risk (AUC 0.609; 95% CI 0.563-0.656) than subcutaneous fat.
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