Abstract
BackgroundAlthough many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. We found previously considerable number of Japanese non-obese subjects (body mass index (BMI) < 25 kg/m2) with visceral fat accumulation and multiple cardiovascular risk factors. The aim of the study was to investigate the difference in clinical features of type 2 diabetic patients with and without visceral fat accumulation, focusing on vascular complications and changes in BMI.MethodsWe enrolled 88 Japanese hospitalized type 2 diabetic patients. Abdominal obesity represented waist circumference (WC) of ≥85 cm for males and ≥90 cm for females (corresponding to visceral fat area of 100 cm2). Subjects were divided into two groups; with or without abdominal obesity.ResultsHypertension, dyslipidemia and cardiovascular diseases were significantly more in the patients with abdominal obesity. The prevalence of cardiovascular disease in the non-obese patients (BMI < 25 kg/m2) with abdominal obesity were similar in obese patients (BMI ≥25 kg/m2). The mean BMI of the patients with abdominal obesity was < 25 kg/m2 at 20 years of age, but reached maximum to more than 30 kg/m2 in the course. Furthermore, substantial portion of the type 2 diabetic patients (52% in males and 43% in females) were not obese at 20 year-old (BMI < 25 kg/m2), but developed abdominal obesity by the time of admission.ConclusionThese results emphasize the need to control multiple risk factors and prevent atherosclerotic disease in patients with abdominal obesity. The significant weight gain after 20 years of age in patients with abdominal obesity stresses the importance of lifestyle modification in younger generation, to prevent potential development of type 2 diabetes and future atherosclerotic cardiovascular disease.
Highlights
Many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years
We reported previously the identification of a considerable proportion of Japanese subjects with visceral fat accumulation whose Body mass index (BMI) was less than 25 kg/ m2, and that subjects with visceral fat accumulation without overall obesity (VFA ≥100 cm2 plus BMI < 25 kg/ m2) had multiple cardiovascular risk factors [12]
The aim of this study is to investigate the difference in clinical features of type 2 diabetic patients with or without abdominal obesity (WC ≥85 cm in males, ≥90 cm in females), with a special focus on vascular complications and changes in BMI
Summary
Many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. There is ample evidence for the role of visceral fat accumulation in the development of multiple metabolic disorders including glucose intolerance, dyslipidemia, elevated blood pressure, and atherosclerotic cardiovascular diseases [13,14,15,16,17,18,19,20] These data suggest that assessment of visceral fat accumulation is useful for evaluation of high-risk group for atherosclerotic cardiovascular diseases, and type 2 diabetes. To date, it has not been well characterized about the state of body weight in younger age of the current type 2 diabetic patients with visceral fat accumulation. It may be important to know whether current type 2 patients with visceral fat accumulation has been obese or not at 20 years of age, to prevent visceral fat accumulation
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