High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes

Ryotaro Bouchi, Takato Takeuchi, Momoko Akihisa, Norihiko Ohara, Yujiro Nakano, Rie Nishitani, Masanori Murakami, Tatsuya Fukuda, Masamichi Fujita, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa

Research output: Contribution to journalArticle

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Abstract

Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis. Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 % female). Visceral fat area (VFA, cm2) and subcutaneous fat area (SFA, cm2) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm2 and VFA < 100 cm2 [S(-)V(-)], SFA ≥ 100 cm2 and VFA < 100 cm2 [S(+)V(-)], SFA < 100 cm2 and VFA ≥ 100 cm2 [S(-)V(+)], and SFA ≥ 100 cm2 and VFA ≥ 100 cm2 [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses. Results: Among the patients examined, 16.3 % were S(-)V(+). Mean (95 % confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100 % male), and S(+)V(-) patients showed female predominance (82 % female). In multivariate linear regression analysis (Adjusted R2 = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model. Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.

Original languageEnglish
Article number136
JournalCardiovascular Diabetology
Volume14
Issue number1
DOIs
Publication statusPublished - Oct 7 2015

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Intra-Abdominal Fat
Subcutaneous Fat
Type 2 Diabetes Mellitus
Atherosclerosis
Abdominal Obesity
Linear Models
Regression Analysis
Abdominal Subcutaneous Fat
Carotid Intima-Media Thickness
Carotid Artery Diseases
Waist Circumference
Dyslipidemias
Ultrasonography
Body Mass Index
Cross-Sectional Studies
Tomography
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

Cite this

High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes. / Bouchi, Ryotaro; Takeuchi, Takato; Akihisa, Momoko; Ohara, Norihiko; Nakano, Yujiro; Nishitani, Rie; Murakami, Masanori; Fukuda, Tatsuya; Fujita, Masamichi; Minami, Isao; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro.

In: Cardiovascular Diabetology, Vol. 14, No. 1, 136, 07.10.2015.

Research output: Contribution to journalArticle

Bouchi, R, Takeuchi, T, Akihisa, M, Ohara, N, Nakano, Y, Nishitani, R, Murakami, M, Fukuda, T, Fujita, M, Minami, I, Izumiyama, H, Hashimoto, K, Yoshimoto, T & Ogawa, Y 2015, 'High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes', Cardiovascular Diabetology, vol. 14, no. 1, 136. https://doi.org/10.1186/s12933-015-0302-4
Bouchi, Ryotaro ; Takeuchi, Takato ; Akihisa, Momoko ; Ohara, Norihiko ; Nakano, Yujiro ; Nishitani, Rie ; Murakami, Masanori ; Fukuda, Tatsuya ; Fujita, Masamichi ; Minami, Isao ; Izumiyama, Hajime ; Hashimoto, Koshi ; Yoshimoto, Takanobu ; Ogawa, Yoshihiro. / High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes. In: Cardiovascular Diabetology. 2015 ; Vol. 14, No. 1.
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abstract = "Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis. Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 {\%} female). Visceral fat area (VFA, cm2) and subcutaneous fat area (SFA, cm2) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm2 and VFA < 100 cm2 [S(-)V(-)], SFA ≥ 100 cm2 and VFA < 100 cm2 [S(+)V(-)], SFA < 100 cm2 and VFA ≥ 100 cm2 [S(-)V(+)], and SFA ≥ 100 cm2 and VFA ≥ 100 cm2 [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses. Results: Among the patients examined, 16.3 {\%} were S(-)V(+). Mean (95 {\%} confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100 {\%} male), and S(+)V(-) patients showed female predominance (82 {\%} female). In multivariate linear regression analysis (Adjusted R2 = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model. Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.",
author = "Ryotaro Bouchi and Takato Takeuchi and Momoko Akihisa and Norihiko Ohara and Yujiro Nakano and Rie Nishitani and Masanori Murakami and Tatsuya Fukuda and Masamichi Fujita and Isao Minami and Hajime Izumiyama and Koshi Hashimoto and Takanobu Yoshimoto and Yoshihiro Ogawa",
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T1 - High visceral fat with low subcutaneous fat accumulation as a determinant of atherosclerosis in patients with type 2 diabetes

AU - Bouchi, Ryotaro

AU - Takeuchi, Takato

AU - Akihisa, Momoko

AU - Ohara, Norihiko

AU - Nakano, Yujiro

AU - Nishitani, Rie

AU - Murakami, Masanori

AU - Fukuda, Tatsuya

AU - Fujita, Masamichi

AU - Minami, Isao

AU - Izumiyama, Hajime

AU - Hashimoto, Koshi

AU - Yoshimoto, Takanobu

AU - Ogawa, Yoshihiro

PY - 2015/10/7

Y1 - 2015/10/7

N2 - Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis. Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 % female). Visceral fat area (VFA, cm2) and subcutaneous fat area (SFA, cm2) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm2 and VFA < 100 cm2 [S(-)V(-)], SFA ≥ 100 cm2 and VFA < 100 cm2 [S(+)V(-)], SFA < 100 cm2 and VFA ≥ 100 cm2 [S(-)V(+)], and SFA ≥ 100 cm2 and VFA ≥ 100 cm2 [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses. Results: Among the patients examined, 16.3 % were S(-)V(+). Mean (95 % confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100 % male), and S(+)V(-) patients showed female predominance (82 % female). In multivariate linear regression analysis (Adjusted R2 = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model. Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.

AB - Background: Abdominal visceral obesity has been reported to be associated with cardiovascular risks than body mass index, waist circumference, and abdominal subcutaneous fat. On the other hand, there is evidence that subcutaneous fat has a beneficial role against cardio-metabolic risks such as diabetes or dyslipidemia. However, little is known regarding the association between high visceral fat with low subcutaneous fat accumulation and the risk for atherosclerosis. Methods: This study was designed to elucidate whether high visceral fat with low subcutaneous fat accumulation enhances the risk for atherosclerosis in patients with type 2 diabetes. This is a cross-sectional study of 148 patients with type 2 diabetes (mean age 65 ± 12 years; 44.5 % female). Visceral fat area (VFA, cm2) and subcutaneous fat area (SFA, cm2) were assessed by abdominal computed tomography. Carotid intima media thickness (CIMT, mm) measured by ultrasonography was used for the assessment of atherosclerosis. Patients were divided into four groups: SFA < 100 cm2 and VFA < 100 cm2 [S(-)V(-)], SFA ≥ 100 cm2 and VFA < 100 cm2 [S(+)V(-)], SFA < 100 cm2 and VFA ≥ 100 cm2 [S(-)V(+)], and SFA ≥ 100 cm2 and VFA ≥ 100 cm2 [S(+)V(+)]. Linear regression analysis with a stepwise procedure was used for the statistical analyses. Results: Among the patients examined, 16.3 % were S(-)V(+). Mean (95 % confidence interval) of CIMT adjusting for age and gender were 0.80 (0.69-0.91), 0.86 (0.72-1.01), 1.28 (1.11-1.44) and 0.83 (0.77-0.88) in patients with S(-)V(-), S(+)V(-), S(-)V(+) and S(+)V(+), respectively (p < 0.001). The S(-)V(+) patients exhibited significantly older than S(-)V(-) patients and those with S(+)V(+) and had a highest VFA-SFA ratio (V/S ratio) among the four groups. S(-)V(+) patients were male predominant (100 % male), and S(+)V(-) patients showed female predominance (82 % female). In multivariate linear regression analysis (Adjusted R2 = 0.549), S(-)V(+) was significantly associated with CIMT (Standardized β 0.423, p < 0.001). Notably, S(+)V(+) was inversely associated with CIMT in the multivariate model. Conclusions: This study provides evidence that high visceral fat with low subcutaneous fat accumulation is an important determinant of carotid atherosclerosis and high subcutaneous fat could be protective against atherosclerosis in patients with type 2 diabetes.

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