Li Xianhua, Wang Yingxiang, Feng Xiaotong, Mao Lin, Ke Jing, Zhao Dong
Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China.
J Diabetes Res. 2025 May 18;2025:3291418. doi: 10.1155/jdr/3291418. eCollection 2025.
The impact of visceral fat area (VFA) on diabetic peripheral neuropathy (DPN) remains controversial in Type 2 diabetes mellitus (T2DM), with conflicting evidence. We conducted a cross-sectional study at the National Metabolic Management Center of Beijing Luhe Hospital between October 2017 and May 2024. VFA was quantified using bioelectrical impedance analysis, and DPN was diagnosed according to standardized clinical criteria. The association between VFA and DPN was examined using multiple logistic regression models with comprehensive confounder adjustment. Nonlinear relationships were investigated through generalized additive models and threshold effect analyses. Among 7436 T2DM patients (3044 females), the median VFA was 104 cm (interquartile range: 79.5-132 cm), with DPN present in 26.55% of participants. Generalized additive models revealed a significant U-shaped association between VFA and DPN, with an inflection point at 133 cm (log-likelihood ratio test, < 0.001). In the segmented regression analysis, each 10 cm increase in VFA below this threshold was associated with decreased DPN risk (OR: 0.95, 95% CI: 0.93-0.97, < 0.05), while increases above the threshold were associated with elevated risk (OR: 1.06, 95% CI: 1.03-1.09, < 0.05). A U-shaped association exists between VFA and DPN prevalence in T2DM patients, suggesting clinical relevance of moderate visceral adiposity.
在2型糖尿病（T2DM）中，内脏脂肪面积（VFA）对糖尿病周围神经病变（DPN）的影响仍存在争议，证据相互矛盾。我们于2017年10月至2024年5月在北京潞河医院国家代谢管理中心进行了一项横断面研究。使用生物电阻抗分析对VFA进行量化，并根据标准化临床标准诊断DPN。使用具有全面混杂因素调整的多重逻辑回归模型检查VFA与DPN之间的关联。通过广义相加模型和阈值效应分析研究非线性关系。在7436例T2DM患者（3044例女性）中，VFA中位数为104 cm（四分位间距：79.5 - 132 cm），26.55%的参与者存在DPN。广义相加模型显示VFA与DPN之间存在显著的U型关联，拐点为133 cm（对数似然比检验，<0.001）。在分段回归分析中，低于该阈值时，VFA每增加10 cm与DPN风险降低相关（比值比：0.95，95%置信区间：0.93 - 0.97，<0.05），而高于阈值时增加则与风险升高相关（比值比：1.06，95%置信区间：1.03 - 1.09，<0.05）。T2DM患者中VFA与DPN患病率之间存在U型关联，提示中度内脏肥胖具有临床相关性。
