Kim Chul Sik, Kim Soo-Kyung, Araneta Maria Rosario G, Lee Eun Jig, Barrett-Connor Elizabeth, Huh Kab Bum
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea; Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, U.S.
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
J Diabetes Complications. 2015 Nov-Dec;29(8):1085-91. doi: 10.1016/j.jdiacomp.2015.06.007. Epub 2015 Jun 19.
Type 2 diabetes mellitus (T2DM) and visceral obesity are associated with each other and with cardiovascular diseases. We determined whether increased visceral adiposity without weight gain was associated with sex-specific accelerated carotid atherosclerosis in South Koreans with T2DM.
From 2003 to 2012, we recruited 280 participants with T2DM for the Seoul Metabolic Syndrome cohort who had body weight, visceral fat thickness (VFT), and carotid intima-media thickness (CIMT) measured at intervals of 2years. According to VFT change, sex-specific quartiles of clinical characteristics and changes of CIMT were determined. Logistic regression models predicted the odds of the progression of CIMTs in each quartile.
During 2years of observation, VFTs fell by 5.2±13.5mm in men (P<0.001) and 3.4±10.5mm in women (P<0.001). Progression of CIMT was only significant for women's maximal CIMT (0.031±0.145mm, P=0.012), while significant improvements in HbA1c were found (0.9%; P<0.001 in both sexes). There were no significant differences in clinical characteristics, or in progression of CIMT in men or women according to 2-year quartiles of VFT change.
Our results do not suggest that increased visceral adiposity without body weight changes impacts the CIMT progression in South Korean men or women with T2DM.
2型糖尿病（T2DM）与内脏肥胖相互关联，且均与心血管疾病相关。我们研究了在无体重增加情况下，内脏脂肪增多是否与韩国T2DM患者中存在的性别特异性颈动脉粥样硬化加速有关。
2003年至2012年，我们招募了280名T2DM患者进入首尔代谢综合征队列研究，这些患者每2年测量一次体重、内脏脂肪厚度（VFT）和颈动脉内膜中层厚度（CIMT）。根据VFT变化，确定临床特征的性别特异性四分位数以及CIMT的变化。逻辑回归模型预测了每个四分位数中CIMT进展的几率。
在2年的观察期内，男性的VFT下降了5.2±13.5mm（P<0.001），女性下降了3.4±10.5mm（P<0.001）。CIMT进展仅在女性最大CIMT时显著（0.031±0.145mm，P=0.012），而糖化血红蛋白（HbA1c）有显著改善（0.9%；男女均P<0.001）。根据2年VFT变化四分位数，男女的临床特征或CIMT进展均无显著差异。
我们的结果表明，在无体重变化情况下内脏脂肪增多，并不会影响韩国T2DM男性或女性的CIMT进展。
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