Shang Chang, Yuan Mengfei, Wang Yue, Wang Yahui, Bao Wujisiguleng, Zeng Shuanghui, Zhang Dandan, Liu Ping, Sun Luying
Department of Nephropathy and Endocrine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Jul 31;17:2869-2880. doi: 10.2147/DMSO.S470836. eCollection 2024.
To investigate the association between visceral obesity and glycemic control in patients with type 2 diabetes mellitus.
A retrospective analysis involved 714 patients diagnosed with type 2 diabetes mellitus from the National Metabolic Management Center from November 2021 to February 2024. Medical data included sociodemographic data, lifestyle behaviors, and anthropometric and biochemical measurements. Multivariate logistic regression analysis was used to analyze their associations.
Among the patients, 251 (35.2%) achieved good glycemic control (HbA1c < 7.0%). On univariate analysis, higher diastolic blood pressure, longer duration of type 2 diabetes mellitus, tobacco smoking, alcohol drinking, insulin treatment, higher levels of fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, total cholesterol, and low-density lipoprotein cholesterol, visceral obesity (visceral fat area ≥ 100cm) and diabetic peripheral neuropathy were all positively correlated with poor glycemic control; female, older age, higher levels of C peptide and serum uric acid were inversely associated with poor glycemic control (all < 0.05). On multivariate logistic regression analysis, the results suggested that higher diastolic blood pressure [OR: 1.021, 95% CI (1.002, 1.040), = 0.030], insulin treatment [currently used: OR = 2.156, 95% CI (1.249, 3.724), = 0.006], higher level of fasting plasma glucose [OR: 1.819, 95% CI (1.598, 2.069), < 0.001], and visceral obesity [OR: 1.876, 95% CI (1.158, 3.038), = 0.011] were risk factors for poor glycemic control.
This study indicated that visceral obesity (visceral fat area ≥ 100cm) is positively associated with poor glycemic control, and serves as an independent risk factor for poor glycemic control (HbA1c ≥ 7.0%) in patients with type 2 diabetes mellitus. Screening for visceral obesity should be emphasized, and targeted interventions should be taken to improve glycemic control in patients with type 2 diabetes mellitus.
探讨2型糖尿病患者内脏肥胖与血糖控制之间的关联。
一项回顾性分析纳入了2021年11月至2024年2月期间来自国家代谢管理中心的714例确诊为2型糖尿病的患者。医疗数据包括社会人口统计学数据、生活方式行为以及人体测量和生化指标测量。采用多因素逻辑回归分析来分析它们之间的关联。
在这些患者中，251例（35.2%）实现了良好的血糖控制（糖化血红蛋白<7.0%）。单因素分析显示，较高的舒张压、2型糖尿病病程较长、吸烟、饮酒、胰岛素治疗、空腹血糖水平较高、胰岛素抵抗稳态模型评估、甘油三酯、总胆固醇和低密度脂蛋白胆固醇、内脏肥胖（内脏脂肪面积≥100cm²）以及糖尿病周围神经病变均与血糖控制不佳呈正相关；女性、年龄较大、C肽和血清尿酸水平较高与血糖控制不佳呈负相关（均P<0.05）。多因素逻辑回归分析结果表明，较高的舒张压[比值比（OR）：1.021，95%置信区间（CI）（1.002，1.040），P = 0.030]、胰岛素治疗（目前使用：OR = 2.156，95%CI（1.249，3.724），P = 0.006）、较高的空腹血糖水平[OR：1.819，95%CI（1.598，2.069），P<0.001]以及内脏肥胖[OR：1.876，95%CI（1.158，3.038），P = 0.011]是血糖控制不佳的危险因素。
本研究表明，内脏肥胖（内脏脂肪面积≥100cm²）与血糖控制不佳呈正相关，并且是2型糖尿病患者血糖控制不佳（糖化血红蛋白≥7.0%）的独立危险因素。应重视对内脏肥胖的筛查，并采取针对性干预措施以改善2型糖尿病患者的血糖控制。
