Ma Xuan, Jiang Xinghe, Gao Guanqi, Ban Bo, Sheng Jie, Shi Shuwei, Zhao Hongyan, Ji Baolan
School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, 261000, People's Republic of China.
Department of Endocrinology, Linyi People's Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong, 276034, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Apr 4;18:1025-1034. doi: 10.2147/DMSO.S506490. eCollection 2025.
Several lipid metabolism-related profiles have been explored for their association with obesity, but no consensus has been reached. Therefore, this study aimed to comprehensively analyze the correlation between conventional and unconventional lipid profiles and visceral fat area (VFA) in overweight/obese patients with type 2 diabetes mellitus (T2DM). Emphasizing the overall relationship between lipid metabolism and visceral fat accumulation.
This cross-sectional study included 1288 overweight/obese T2DM patients, with VFA measured using bioelectrical impedance analysis and visceral fat obesity (VFO) was defined as VFA ≥ 100 cm². Both conventional lipid profiles include total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and lipoprotein(a), and unconventional lipid profiles include lipid composite index (LCI), platelet/ HDL-c ratio (PHR), remnant cholesterol (RC), TG/HDL-c, Castelli Risk Index I (CRI-I), Castelli Risk Index II (CRI-II), Non-HDL-c, atherogenic index of plasma (AIP) and atherogenic coefficient (AC) were analyzed. The study population was divided into non-VFO and VFO groups, The relationship between conventional and unconventional lipid profiles and VFO was evaluated.
Compared to the non-VFO group, the VFO group exhibited significantly higher levels of TG, lipoprotein(a), LCI, RC, TG/HDL-c, CRI-I, CRI-II, AIP, and AC (all P < 0.05). Univariate analysis revealed that RC, TG, LCI, TG/HDL-c, CRI-I, CRI-II, AIP, and AC were positively correlated with VFA and VFO, while HDL-c and lipoprotein(a) were negatively correlated (all P < 0.05). Logistic regression identified RC as an independent risk factor for VFO (OR: 1.667, 95% CI: 1.216-2.285, P = 0.001).
Among lipid profiles, RC is independently and significantly associated with VFO, underscoring its role in lipid metabolism and abdominal obesity management, especially in overweight/obese T2DM patients.
已经对几种脂质代谢相关指标与肥胖的关联进行了探索,但尚未达成共识。因此,本研究旨在全面分析超重/肥胖2型糖尿病(T2DM)患者中传统和非传统脂质指标与内脏脂肪面积(VFA)之间的相关性。强调脂质代谢与内脏脂肪堆积之间的整体关系。
这项横断面研究纳入了1288例超重/肥胖T2DM患者,使用生物电阻抗分析测量VFA,并将内脏脂肪肥胖(VFO)定义为VFA≥100cm²。传统脂质指标包括总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)和脂蛋白(a),非传统脂质指标包括脂质综合指数(LCI)、血小板/HDL-c比值(PHR)、残余胆固醇(RC)、TG/HDL-c、卡斯泰利风险指数I(CRI-I)、卡斯泰利风险指数II(CRI-II)、非HDL-c、血浆致动脉粥样硬化指数(AIP)和致动脉粥样硬化系数(AC),并进行分析。研究人群分为非VFO组和VFO组,评估传统和非传统脂质指标与VFO之间的关系。
与非VFO组相比,VFO组的TG、脂蛋白(a)、LCI、RC、TG/HDL-c、CRI-I、CRI-II、AIP和AC水平显著更高(所有P<0.05)。单因素分析显示,RC、TG、LCI、TG/HDL-c、CRI-I、CRI-II、AIP和AC与VFA和VFO呈正相关,而HDL-c和脂蛋白(a)呈负相关(所有P<0.05)。Logistic回归确定RC是VFO的独立危险因素(OR:1.667,95%CI:1.216-2.285,P=0.001)。
在脂质指标中,RC与VFO独立且显著相关,突出了其在脂质代谢和腹部肥胖管理中的作用,尤其是在超重/肥胖T2DM患者中。