Abstract

Aim: This case–control study aimed to investigate the interrelations of body measurements and selected biomarkers in type 2 diabetes mellitus (T2DM).Methods: We recruited 98 patients with T2DM and 98 controls from 2016 to 2018 in Taiwan. Body measurements were obtained using a three-dimensional body surface scanning system. Four biomarkers related to insulin resistance, adipokines, and inflammation were assayed. A multiple logistic regression model was used to perform multivariable analyses.Results: Four body measurements, namely waist circumference (odds ratio, OR = 1.073; 95% confidence interval, CI = 1.017–1.133), forearm circumference (OR = 1.227; 95% CI = 1.002–1.501), thigh circumference (OR = 0.841; 95% CI = 0.73–0.969), and calf circumference (OR = 1.25; 95% CI = 1.076–1.451), were significantly associated with T2DM. Leptin (OR = 1.09; 95% CI = 1.036–1.146) and adiponectin (OR = 0.982; 95% CI = 0.967–0.997) were significantly associated with T2DM. Six body measurement combinations, namely body mass index, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, forearm-to-thigh ratio, and calf-to-thigh ratio (CTR), were significantly associated with T2DM. CTR had the strongest linear association with T2DM. Moderating effects of significant biomarkers, namely leptin and adiponectin, were observed. Participants with high leptin-to-adiponectin ratios and in the fourth CTR quartile were 162.2 times more prone to develop T2DM.Conclusions: We concluded that a combination of leptin and adiponectin modulated the strength of the association between body measurements and T2DM while providing clues for high-risk group identification and mechanistic conjectures of preventing T2DM.

Highlights

  • Type 2 diabetes mellitus (T2DM) is a rapidly burgeoning chronic disease that causes complications resulting in increased healthcare burden and affecting patient quality of life [1, 2]

  • The results of the multivariable analysis indicated that waist circumference (WC) (OR = 1.073; 95% CI = 1.017–1.133), left forearm circumference (OR = 1.227; 95% CI = 1.002–1.501), right thigh circumference (TC) (OR = 0.841; 95% CI = 0.73–0.969), and right calf circumference (OR = 1.25; 95% CI = 1.076–1.451) were significantly associated with T2DM after adjusting for age, sex, education, marital status, occupation, smoking, alcohol drinking, coffee drinking, betel nut chewing, and daily activity level

  • The following six selected combinations were significantly associated with T2DM in the multivariable logistic regression analysis: body mass index (BMI) (OR = 1.318; 95% CI = 1.171–1.483), waist-to-hip ratio (WHR) (OR = 1.109; 95% CI = 1.046–1.176), waist-to-height ratio (WHtR) (OR = 1.162; 95% CI = 1.086–1.243), waistto-thigh ratio (WTR) (OR = 1.534; 95% CI = 1.229– 1.913), FATR (OR = 1.12; 95% CI = 1.047–1.197), and CTR (OR = 1.142; 95% CI = 1.075–1.214) (Table 2)

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Summary

Introduction

Type 2 diabetes mellitus (T2DM) is a rapidly burgeoning chronic disease that causes complications resulting in increased healthcare burden and affecting patient quality of life [1, 2]. Studies have demonstrated that central obesity, or abdominal visceral fat accumulation, predominantly indicates T2DM risk and is associated with inflammatory response mechanisms and insulin resistance [3]. A meta-analysis indicated that body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are three major body shape markers associated with T2DM incidence [4]. Another meta-analysis indicated that waist-to-height ratio (WHtR) was superior to BMI in predicting diabetes and several other cardiometabolic risk factors [5]. WC is an indicator of abdominal visceral fat accumulation and is associated with insulin resistance and cardiometabolic risk [6,7,8,9]. The association among body measurements, T2DM, and biomarkers related to insulin resistance and inflammation requires clarification

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