Visceral Fat Area, Not Subcutaneous Fat Area, is Associated with Cardiac Hemodynamics in Type 2 Diabetes.

Background: This study was conducted in patients with type 2 diabetes mellitus (T2DM) to assess the association between visceral fat area (VFA) and cardiac hemodynamics.

Methods: A total of 568 patients with type 2 diabetes (mean age 54±12 years; 40.8% of women) were enrolled. Visceral fat area (VFA, m) and subcutaneous fat area (SFA, m) were evaluated by a bioelectrical impedance analyzer. Cardiac hemodynamics were measured by echocardiography, and other clinical and laboratory variables were also assessed and recorded. Patients were divided into those with VFA ≤ 100 (n=369) and those with VFA > 100 (n=199).

Results: VFA, SFA, LVMI (left ventricular mass index), left atrial diameter, left ventricular diastolic diameter (LvDd), interventricular septal thickness (IVST), left ventricular systolic diameter (LvSd), and posterior wall thickness (PWT) levels in high-V groups were significantly higher than those in low-V groups. Correlation analysis showed that VFA was positively correlated with LVMI (=0.120, =0.004), LVM (=0.249, <0.0001), left atrial diameter (=0.375, <0.0001), aortic root diameter (=0.243, <0.0001), left ventricular systolic diameter (LvSd) (=0.211, <0.0001) and negatively correlated with LVEF (=-0.107, =0.011). In multivariate linear regression analysis, VFA was the strongest independent determinant of LVMI (=0.04, =0.016), LVEF (=-0.01, =0.023), and left atrial diameter (=0.035, <0.0001), Internal diameter of the aortic root (=0.014, <0.0001) and LvSd (=0.017, <0.0001). In addition, the VFA also better predicted cardiovascular disease risk with AUC of 0.609 (95% CI:0.563-0.656), compared with SFA, waist-hip ratio (WHR), in a statistically significant manner.

Conclusion: We found a significant correlation between VFA (but not SFA) and cardiac hemodynamic parameters. The VFA has advantages as a predictor of visceral obesity and is significantly associated with the development of cardiovascular risk factors (CVD) in T2DM patients.