Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.
Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China.
Diabetes Metab Res Rev. 2020 Jan;36(1):e3198. doi: 10.1002/dmrr.3198. Epub 2019 Jul 15.
Visceral adiposity and albuminuria are commonly observed in patients with type 2 diabetes mellitus (T2DM). Recently, the visceral adipose index (VAI) was found to be an indicator of visceral fat accumulation. However, the relationship between the VAI and urinary albumin has not been investigated in T2DM patients, and whether the predictive value of the VAI is superior to that of the triglyceride/high-density lipoprotein cholesterol (TG/HDL-c) ratio remains unknown.
Three hundred and forty one newly diagnosed T2DM patients were enrolled. The anthropometric parameters, blood pressure, glucose, lipid profiles, urinary albumin, and other biochemical indices were examined. Linear and logistic regression models were developed to assess the association between the VAI and urinary albumin.
The prevalence of microalbuminuria was 41.3% (n = 141) and increased with increasing levels of VAI. An age-adjusted partial correlation analysis showed that the VAI and TG/HDL-c ratio were significantly associated with the waist-to-hip ratio, heart rate, total cholesterol, low-density lipoprotein cholesterol, and uric acid. In the stepwise linear regression analysis, the VAI (β = .21, .009) and TG/HDL-c (β = .25, .002) were significant determinants of urinary albumin. Moreover, in the multiple logistic regression model, the odds ratio (OR) of microalbuminuria per one SD increase in the VAI was 1.94 (95% CI, 1.11-3.38), and a similar result was observed with a higher TG/HDL-c ratio (OR = 2.03, 95% CI, 1.13-3.65).
We are the first to show a clear association between the VAI and urinary albumin in Chinese type 2 diabetic patients. Additionally, the VAI and TG/HDL-c ratio had similar predictive power regarding albuminuria risk. The VAI could be a rapid and reliable tool for assessing early-stage renal damage in newly diagnosed T2DM patients.
内脏肥胖和白蛋白尿在 2 型糖尿病（T2DM）患者中很常见。最近，内脏脂肪指数（VAI）被发现是内脏脂肪堆积的一个指标。然而，VAI 与尿白蛋白之间的关系在 T2DM 患者中尚未得到研究，VAI 的预测价值是否优于甘油三酯/高密度脂蛋白胆固醇（TG/HDL-c）比值仍不清楚。
纳入 341 例新诊断的 T2DM 患者。检查了人体测量参数、血压、血糖、血脂谱、尿白蛋白和其他生化指标。采用线性和逻辑回归模型评估 VAI 与尿白蛋白之间的关系。
微量白蛋白尿的患病率为 41.3%（n=141），并随 VAI 水平的升高而增加。年龄调整的偏相关分析显示，VAI 和 TG/HDL-c 比值与腰臀比、心率、总胆固醇、低密度脂蛋白胆固醇和尿酸显著相关。在逐步线性回归分析中，VAI（β=0.21，P=0.009）和 TG/HDL-c（β=0.25，P=0.002）是尿白蛋白的显著决定因素。此外，在多因素逻辑回归模型中，VAI 每增加一个标准差，微量白蛋白尿的优势比（OR）为 1.94（95%可信区间，1.11-3.38），而 TG/HDL-c 比值较高时也观察到类似的结果（OR=2.03，95%可信区间，1.13-3.65）。
我们首次在中国人 2 型糖尿病患者中明确显示 VAI 与尿白蛋白之间存在关联。此外，VAI 和 TG/HDL-c 比值对白蛋白尿风险具有相似的预测能力。VAI 可能是评估新诊断的 T2DM 患者早期肾损伤的一种快速可靠的工具。
