Truncal fat has been reported to be positively associated with the risk of metabolic syndrome (MS), type 2 diabetes (T2D), and cardiovascular disease (CVD). Meanwhile, leg fat was inversely related to MS, T2D, and CVD. This study examined the association between truncal fat to leg fat ratio (TLR) and the prevalence of CVD in patients with T2D. A total of 1,728 individuals with T2D were enrolled. Truncal fat, leg fat, and appendicular muscle mass (ASM) were assessed using dual-energy X-ray absorptiometry. All subjects were divided into 3 groups according to the tertile of TLR. CVD was defined as either coronary heart disease (CHD), ischemic stroke (IS), peripheral artery disease (PAD), or a combination these conditions. The prevalence of CVD, CHD, IS, and PAD were 24.8%, 17.4%, 7.5%, and 3.3%, respectively. Individuals with CVD were highly likely to be older, male, and hypertensive and had higher values for diabetic duration (DD), waist circumference (WC), and TLR, but lower values for diastolic blood pressure, HDL cholesterol, and estimated glomerular filtration rate (eGFR) than those without CVD. Patients with the highest TLR tertile were more likely to be elderly and hypertensive and had higher values for DD, WC, BMI, triglycerides (TG), HbA1c, and HOMA-IR, but lower values for HDL cholesterol, eGFR, and ASM/BMI, compared with those with the lowest tertile. The prevalence of CVD progressively increased with greatening tertile of TLR (the lowest vs. the middle vs, the highest = 19.4% vs. 26.0% vs. 29.1%, p = 0.001). The odd ratios (ORs) and 95% confidence intervals (IC) for the presence of CVD after adjusting age and sex, were 1.25 (0.93 - 1.69) in the middle and 1.51 (1.13 - 2.02) in the highest, respectively. The ORs and 95% CI in the highest tertile remained significant, further adjusting for WC, BMI, current smoker, DD, hypertension, HDL, TG, HOMA-IR, HbA1c, CRP, and eGFR.

In conclusion, we found that TLR was significantly associated with CVD in patients with T2D independently of potential confounders.

Disclosure

J. Shin: None.

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