Ratio of visceral-to-subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes

Tatsuya Fukuda, Ryotaro Bouchi, Takato Takeuchi, Yujiro Nakano, Masanori Murakami, Isao Minami, Hajime Izumiyama, Koshi Hashimoto, Takanobu Yoshimoto, Yoshihiro Ogawa

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims/Introduction: To investigate whether the ratio of visceral fat area (VFA) to subcutaneous fat area (SFA; V/S ratio) could be predictive of cardiovascular disease (CVD) as compared with VFA or SFA in patients with diabetes. Materials and Methods: A total of 682 patients with type 2 diabetes (mean age 64 ± 13 years; 41% women) were enrolled. VFA (cm2) and SFA (cm2) were assessed by a dual bioelectrical impedance analyzer. The patients were divided into four groups according to the quartiles of the V/S ratio. The study end-point was the first occurrence or recurrence of CVD. Results: Over a median follow up of 2.5 years, 21 patients reached the end-point. The number of patients who reached the end-point was increased along with the increasing of the V/S ratio quartiles. The V/S ratio was significantly associated with incident or recurrent CVD (hazard ratio [HR] 1.82, 95% CI: 1.09–3.04, P = 0.021) after adjusting for estimated glomerular filtration rate (HR 0.98, 95% CI: 0.96–1.00), brain-type natriuretic peptide (HR 1.00, 95% CI: 1.00–1.01), use of antiplatelet agents (HR 4.26, 95% CI: 1.63–11.13), coefficient of variation of R-R intervals (HR 0.85, 95% CI: 0.69–1.10) and glycated hemoglobin (HR 1.37, 95% CI: 1.05–1.79). The addition of the V/S ratio to age, estimated glomerular filtration rate, brain-type natriuretic peptide, antiplatelet agents and glycated hemoglobin significantly improved classification performance for CVD using net reclassification improvement (0.60, 95% CI: 0.21–1.00) and the integrated discrimination improvement (0.02, 95% CI: 0.00–0.05). Conclusions: The V/S ratio measured by dual bioelectrical impedance analyzer is an independent predictor of CVD in patients with type 2 diabetes.

Original languageEnglish
Pages (from-to)396-402
Number of pages7
JournalJournal of Diabetes Investigation
Volume9
Issue number2
DOIs
Publication statusPublished - Mar 2018

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Subcutaneous Fat
Type 2 Diabetes Mellitus
Cardiovascular Diseases
Intra-Abdominal Fat
Brain Natriuretic Peptide
Platelet Aggregation Inhibitors
Glycosylated Hemoglobin A
Electric Impedance
Glomerular Filtration Rate
Recurrence

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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Ratio of visceral-to-subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes. / Fukuda, Tatsuya; Bouchi, Ryotaro; Takeuchi, Takato; Nakano, Yujiro; Murakami, Masanori; Minami, Isao; Izumiyama, Hajime; Hashimoto, Koshi; Yoshimoto, Takanobu; Ogawa, Yoshihiro.

In: Journal of Diabetes Investigation, Vol. 9, No. 2, 03.2018, p. 396-402.

Research output: Contribution to journalArticle

Fukuda, T, Bouchi, R, Takeuchi, T, Nakano, Y, Murakami, M, Minami, I, Izumiyama, H, Hashimoto, K, Yoshimoto, T & Ogawa, Y 2018, 'Ratio of visceral-to-subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes', Journal of Diabetes Investigation, vol. 9, no. 2, pp. 396-402. https://doi.org/10.1111/jdi.12713
Fukuda, Tatsuya ; Bouchi, Ryotaro ; Takeuchi, Takato ; Nakano, Yujiro ; Murakami, Masanori ; Minami, Isao ; Izumiyama, Hajime ; Hashimoto, Koshi ; Yoshimoto, Takanobu ; Ogawa, Yoshihiro. / Ratio of visceral-to-subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes. In: Journal of Diabetes Investigation. 2018 ; Vol. 9, No. 2. pp. 396-402.
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abstract = "Aims/Introduction: To investigate whether the ratio of visceral fat area (VFA) to subcutaneous fat area (SFA; V/S ratio) could be predictive of cardiovascular disease (CVD) as compared with VFA or SFA in patients with diabetes. Materials and Methods: A total of 682 patients with type 2 diabetes (mean age 64 ± 13 years; 41{\%} women) were enrolled. VFA (cm2) and SFA (cm2) were assessed by a dual bioelectrical impedance analyzer. The patients were divided into four groups according to the quartiles of the V/S ratio. The study end-point was the first occurrence or recurrence of CVD. Results: Over a median follow up of 2.5 years, 21 patients reached the end-point. The number of patients who reached the end-point was increased along with the increasing of the V/S ratio quartiles. The V/S ratio was significantly associated with incident or recurrent CVD (hazard ratio [HR] 1.82, 95{\%} CI: 1.09–3.04, P = 0.021) after adjusting for estimated glomerular filtration rate (HR 0.98, 95{\%} CI: 0.96–1.00), brain-type natriuretic peptide (HR 1.00, 95{\%} CI: 1.00–1.01), use of antiplatelet agents (HR 4.26, 95{\%} CI: 1.63–11.13), coefficient of variation of R-R intervals (HR 0.85, 95{\%} CI: 0.69–1.10) and glycated hemoglobin (HR 1.37, 95{\%} CI: 1.05–1.79). The addition of the V/S ratio to age, estimated glomerular filtration rate, brain-type natriuretic peptide, antiplatelet agents and glycated hemoglobin significantly improved classification performance for CVD using net reclassification improvement (0.60, 95{\%} CI: 0.21–1.00) and the integrated discrimination improvement (0.02, 95{\%} CI: 0.00–0.05). Conclusions: The V/S ratio measured by dual bioelectrical impedance analyzer is an independent predictor of CVD in patients with type 2 diabetes.",
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AU - Fukuda, Tatsuya

AU - Bouchi, Ryotaro

AU - Takeuchi, Takato

AU - Nakano, Yujiro

AU - Murakami, Masanori

AU - Minami, Isao

AU - Izumiyama, Hajime

AU - Hashimoto, Koshi

AU - Yoshimoto, Takanobu

AU - Ogawa, Yoshihiro

PY - 2018/3

Y1 - 2018/3

N2 - Aims/Introduction: To investigate whether the ratio of visceral fat area (VFA) to subcutaneous fat area (SFA; V/S ratio) could be predictive of cardiovascular disease (CVD) as compared with VFA or SFA in patients with diabetes. Materials and Methods: A total of 682 patients with type 2 diabetes (mean age 64 ± 13 years; 41% women) were enrolled. VFA (cm2) and SFA (cm2) were assessed by a dual bioelectrical impedance analyzer. The patients were divided into four groups according to the quartiles of the V/S ratio. The study end-point was the first occurrence or recurrence of CVD. Results: Over a median follow up of 2.5 years, 21 patients reached the end-point. The number of patients who reached the end-point was increased along with the increasing of the V/S ratio quartiles. The V/S ratio was significantly associated with incident or recurrent CVD (hazard ratio [HR] 1.82, 95% CI: 1.09–3.04, P = 0.021) after adjusting for estimated glomerular filtration rate (HR 0.98, 95% CI: 0.96–1.00), brain-type natriuretic peptide (HR 1.00, 95% CI: 1.00–1.01), use of antiplatelet agents (HR 4.26, 95% CI: 1.63–11.13), coefficient of variation of R-R intervals (HR 0.85, 95% CI: 0.69–1.10) and glycated hemoglobin (HR 1.37, 95% CI: 1.05–1.79). The addition of the V/S ratio to age, estimated glomerular filtration rate, brain-type natriuretic peptide, antiplatelet agents and glycated hemoglobin significantly improved classification performance for CVD using net reclassification improvement (0.60, 95% CI: 0.21–1.00) and the integrated discrimination improvement (0.02, 95% CI: 0.00–0.05). Conclusions: The V/S ratio measured by dual bioelectrical impedance analyzer is an independent predictor of CVD in patients with type 2 diabetes.

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