Relationship Between Skeletal Muscle Mass to Visceral Fat Area Ratio and Cardiovascular Risk in Type 2 Diabetes.
Relationship Between Skeletal Muscle Mass to Visceral Fat Area Ratio and Cardiovascular Risk in Type 2 Diabetes.
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2 型糖尿病患者骨骼肌质量与内脏脂肪面积比与心血管风险之间的关系
DOI：
10.2147/dmso.s326195
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Chen H
中科院分区：
文献类型：
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作者：
Liu D;Zhong J;Wen W;Ruan Y;Zhang Z;Sun J;Chen H
内脏脂肪或肌肉质量被确定与心脏代谢疾病相关，特别是在2型糖尿病（T2 DM）中。但是，内脏脂肪沿着骨骼肌对2型糖尿病心血管疾病（CVD）风险的协同作用仍存在争议。因此，我们研究了骨骼肌质量与内脏脂肪面积比（SVR）和10年CVD风险评分之间的关系。本研究共入组了291例年龄为40-80岁的T2 DM患者。基于生物电阻抗测量评价SVR。采用Fragrance风险评分系统和China-PAR风险模型对T2 DM人群未来10年心血管疾病风险进行评估。2型糖尿病患者10年CVD风险评分随SVR三分位数的降低而增加（P均<0.001）。高危组SVR值明显低于低、中危组（均P<0.05）。然而，不同CVD风险组之间的BMI无显著差异。此外，SVR与Fragrance风险评分（r=-0.408; P<0.001）和China-PAR风险评分（r=-0.336; P<0.001）相关。HOMA-IR、甘油三酯、血压与SVR呈负相关（均P<0.05）。此外，在调整混杂因素（包括年龄、性别、BMI、FPG、HbA 1c、糖尿病病程、白蛋白、肌酐、尿酸、吸烟、血压和血脂）后，SVR值与法国10年CVD风险评分（β = − 0.074，P = 0.047）和中国PAR风险评分（β=−0.100，P=0.004）独立相关。对男性和女性分别进行了线性回归分析，表明SVR和10年CVD风险之间的负相关关系在男性中观察到，但在女性中没有观察到。SVR值较低的T2 DM人群更可能增加CVD风险。SVR水平与T2 DM患者10年CVD风险呈显著负相关，表明SVR可能是临床实践中评估CVD事件风险的一个有价值的参数，尤其是在男性中。
Either visceral fat or muscle mass is identified to be correlated with cardiometabolic diseases, especially in type 2 diabetes (T2DM). But, the synergistical effect of visceral fat along with skeletal muscle on the risk of cardiovascular diseases (CVD) in T2DM still remains controversial. Thus, we investigated the relationship between skeletal muscle mass to visceral fat area ratio (SVR) and 10-yr CVD risk scores. A total of 291 T2DM patients aged 40–80 years were enrolled in the current study. SVR was evaluated based on bioelectrical impedance measurements. Both Framingham risk score system and China-PAR risk model were applied to estimate future 10-yr CVD risk in T2DM population. The 10-yr CVD risk scores increased with the decreased SVR tertiles in T2DM (All P<0.001). SVR value was obviously lower in the high-risk group than that of low- or moderate-risk group (All P<0.05). However, no significant differences were observed in BMI among different CVD risk groups. Besides, SVR was correlated with Framingham risk score (r=−0.408; P<0.001) and China-PAR risk score (r=−0.336; P<0.001). HOMA-IR, triglycerides and blood pressure were also inversely related to SVR (All P<0.05). Furthermore, SVR value was independently correlated with both Framingham 10-yr CVD risk score (β=−0.074, P=0.047) and China-PAR risk score (β=−0.100, P=0.004) after adjustment for confounding factors, including age, gender, BMI, FPG, HbA1c, diabetes duration, albumin, creatinine, uric acid, smoking, blood pressure and blood lipid. The linear regression analysis was also conducted for men and women, respectively, indicating that the negative relationship between SVR and 10-yr CVD risk was observed in men but not in women. T2DM populations who have lower SVR value are more likely to increase CVD risk. SVR levels show marked and inverse correlation with estimated 10-yr CVD risk in T2DM, indicating that SVR could be a valuable parameter to assess the risk of CVD events in clinical practice, especially in men.