Yokokawa Hirohide, Fukuda Hiroshi, Saita Mizue, Goto Kento, Kaku Tengen, Miyagami Taiju, Takahashi Yuichi, Hamada Chieko, Hisaoka Teruhiko, Naito Toshio
Department of General Medicine, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Department of General Medicine, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Diabetol Metab Syndr. 2021 Apr 14;13(1):44. doi: 10.1186/s13098-021-00646-3.
The impact of subcutaneous fat accumulation remains controversial. This study assessed the association between visceral or subcutaneous fat area (VFA and SFA, respectively) and diabetes mellitus (DM) among Japanese subjects.
This was a cross-sectional study involving 1907 eligible participants (men, 1050; women, 857) who participated in a voluntary health check-up conducted at Juntendo University Hospital from January 2017 to December 2018, in Tokyo, Japan. Associations between VFA or SFA quartiles and DM were identified using adjusted odds ratios (AORs) and 95% confidence intervals (CIs) with multivariable logistic regression analysis adjusted for confounders. Receiver operating characteristic (ROC) curve analysis was used to assess appropriate cut-off values of VFA or SFA.
Multivariate analyses showed that Q4 (≥ 125 cm) of VFA was significantly positively associated with DM compared to Q1 (< 65 cm) (AOR = 1.94, 95% CI 1.02-3.71), whereas there was no association between SFA and DM in men. Among women, Q4 (≥ 85 cm) of VFA was significantly positively associated with DM compared to Q1 (< 30 cm) (Q4, AOR = 6.15, 95% CI 1.65-22.99). Also, Q3 and Q4 (≥ 135 cm) of SFA were significantly positively associated with DM compared to Q1 (< 90 cm) (Q3, AOR = 5.64, 95% CI 1.21-26.25; Q4, AOR = 7.81, 95% CI 1.71-35.65). The appropriate cut-off value of VFA in men was 101.5 cm. Those of VFA and SFA in women were 72.5 cm and 165.3 cm, respectively.
Our results suggest the importance of considering SFA as well as VFA, especially in women, for primary and secondary prevention of DM.
皮下脂肪堆积的影响仍存在争议。本研究评估了日本受试者内脏脂肪面积或皮下脂肪面积(分别为VFA和SFA)与糖尿病(DM)之间的关联。
这是一项横断面研究,纳入了1907名符合条件的参与者(男性1050名,女性857名),他们于2017年1月至2018年12月在日本东京顺天堂大学医院参加了自愿健康检查。通过多变量逻辑回归分析调整混杂因素,使用调整后的优势比(AOR)和95%置信区间(CI)来确定VFA或SFA四分位数与DM之间的关联。采用受试者工作特征(ROC)曲线分析来评估VFA或SFA的合适截断值。
多变量分析显示,与第一四分位数(<65 cm)相比,VFA的第四四分位数(≥125 cm)与DM显著正相关(AOR = 1.94,95% CI 1.02 - 3.71),而男性中SFA与DM无关联。在女性中,与第一四分位数(<30 cm)相比,VFA的第四四分位数(≥85 cm)与DM显著正相关(第四四分位数,AOR = 6.15,95% CI 1.65 - 22.99)。此外,与第一四分位数(<90 cm)相比,SFA的第三和第四四分位数(≥135 cm)与DM显著正相关(第三四分位数,AOR = 5.64,95% CI 1.21 - 26.25;第四四分位数,AOR = 7.81,95% CI 1.71 - 35.65)。男性中VFA的合适截断值为101.5 cm。女性中VFA和SFA的合适截断值分别为72.5 cm和165.3 cm。
我们的结果表明,在DM的一级和二级预防中,尤其是在女性中,考虑SFA以及VFA具有重要意义。