Open AccessRatio of visceral‐to‐subcutaneous fat area predicts cardiovascular events in patients with type 2 diabetes
Author(s) -
Fukuda Tatsuya,
Bouchi Ryotaro,
Takeuchi Takato,
Nakano Yujiro,
Murakami Masanori,
Minami Isao,
Izumiyama Hajime,
Hashimoto Koshi,
Yoshimoto Takanobu,
Ogawa Yoshihiro
Publication year - 2018
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12713
Subject(s) - medicine , bioelectrical impedance analysis , type 2 diabetes , glycated hemoglobin , hazard ratio , diabetes mellitus , quartile , renal function , gastroenterology , confidence interval , cardiology , endocrinology , body mass index
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 (cm 2 ) and SFA (cm 2 ) 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.