Normal-weight visceral obesity in patients with type 2 diabetes was associated with a significantly higher 10-year ASCVD risk compared to being overweight without visceral obesity (OR 2.429).
Observational (n=6,997)
Yes
Does normal-weight visceral obesity increase the 10-year ASCVD risk in patients with T2DM compared to BMI-defined overweight or obesity?
Normal-weight visceral obesity in patients with T2DM is associated with a significantly higher 10-year ASCVD risk than BMI-defined overweight or obesity without visceral obesity.
Effect estimate: OR 2.429 (95% CI 1.413-4.175)
p-value: p=0.001
Abstract Background Visceral obesity is associated with high cardiovascular events risk in type 2 diabetes mellitus (T2DM). Whether normal-weight visceral obesity will pose a higher atherosclerotic cardiovascular disease (ASCVD) risk than body mass index (BMI)-defined overweight or obese counterparts with or without visceral obesity remains unclear. We aimed to explore the relationship between general obesity and visceral obesity and 10-year ASCVD risk in patients with T2DM. Methods Patients with T2DM (6997) who satisfied the requirements for inclusion were enrolled. Patients were considered to have normal weight when 18.5 kg/m 2 ≤ BMI < 24 kg/m 2 ; overweight when 24 kg/m 2 ≤ BMI < 28 kg/m 2 ; and obesity when BMI ≥ 28 kg/m 2 . Visceral obesity was defined as a visceral fat area (VFA) ≥ 100 cm 2 . Patients were separated into six groups based on BMI and VFA. The odd ratios (OR) for a high 10-year ASCVD risk for different combinations of BMI and VFA were analysed using stepwise logistic regression. Receiver operating characteristic (ROC) curves for diagnosing the high 10-year ASCVD risk were constructed, and areas under the ROC curves were estimated. Potential non-linear relationships between VFA levels and high 10-year ASCVD risk were examined using restricted cubic splines (knot = 4). Multilinear regression was used to identify factors affecting VFA in patients with T2DM. Results In patients with T2DM, subjects with normal-weight visceral obesity had the highest 10-year ASCVD risk among the six groups, which had more than a 2-fold or 3-fold higher OR than those who were overweight or obese according to BMI but did not have visceral obesity (all P < 0.05). The VFA threshold for high 10-year ASCVD risk was 90 cm 2 . Multilinear regression showed significant differences in the effect of age, hypertension, drinking, fasting serum insulin, fasting plasma glucose, 2 h postprandial C-peptide, triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on VFA in patients with T2DM (all P < 0.05). Conclusions T2DM patients with normal-weight visceral obesity had a higher 10-year ASCVD risk than BMI-defined overweight or obese counterparts with or without visceral obesity, which should initiate standardised management for ASCVD primary prevention.
Zheng et al. (Mon,) conducted a observational in Type 2 diabetes mellitus (n=6,997). Normal-weight visceral obesity vs. Overweight without visceral obesity was evaluated on High 10-year ASCVD risk (OR 2.429, 95% CI 1.413-4.175, p=0.001). Normal-weight visceral obesity in patients with type 2 diabetes was associated with a significantly higher 10-year ASCVD risk compared to being overweight without visceral obesity (OR 2.429).