Association of visceral fat area or BMI with arterial stiffness in ideal cardiovascular health metrics among T2DM patients

作者：Ling Zhao, Xiangming Zhou, Yufei Chen, Qijuan Dong, Qidong Zheng, Yufan Wang, Li Li, Dong Zhao, Bangqun Ji, Fengmei Xu, Juan Shi, Ying Peng, Yifei Zhang, Yuancheng Dai, Tingyu Ke, Weiqing Wang · 发表于：Journal of Diabetes · 年份：2023 · DOI：10.1111/1753-0407.13463 · 被引用次数：13 · 研究领域：Cardiovascular Health and Disease Prevention、Diabetes, Cardiovascular Risks, and Lipoproteins、Cardiovascular Function and Risk Factors

Abstract Background “Obesity paradox” occurs in type 2 diabetes mellitus (T2DM) patients when body mass index (BMI) is applied to define obesity. We examined the association of visceral fat area (VFA) as an obesity measurement with arterial stiffness in seven ideal cardiovascular health metrics (ICVHMs). Methods A total of 29 048 patients were included in the analysis from June 2017 to April 2021 in 10 sites of National Metabolic Management Centers. ICVHMs were modified from the recommendations of the American Heart Association. Brachial‐ankle pulse wave velocity (BaPWV) ≥ 1400 cm/s was employed to evaluate increased arterial stiffness. Multivariate regression models were used to compare the different effects of BMI and VFA on arterial stiffness. Results Lower VFA was more strongly associated with low BaPWV than lower BMI when other ICVHMs were included (adjusted odds ratio [OR], 0.85 [95% confidence interval [CI], 0.80–0.90] vs OR 1.08 [95% CI, 1.00–1.17]). Multivariable‐adjusted ORs for arterial stiffness were highest in patients with the VAT area VFA in the range of 150‐200 cm 2 (adjusted OR, 1.26 [95% CI 1.12–1.41]). Compared with participants with VAT VFA < 100 cm 2 , among participants with higher VAT VFA, the OR for arterial stiffness decreased gradually from 1.89 (95% CI, 1.73–2.07) in patients who had ≤1 ICVHM to 0.39 (95% CI, 0.25–0.62) in patients who had ≥5 ICVHMs. Conclusion In patients with T2DM, using VAT for anthropometric measures of obesity, VFA was more ...