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, m²) and subcutaneous fat area (SFA, m²) 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 (r =0.120, p =0.004), LVM (r =0.249, p < 0.0001), left atrial diameter (r =0.375, p < 0.0001), aortic root diameter (r =0.243, p < 0.0001), left ventricular systolic diameter (LvSd) (r =0.211, p < 0.0001) and negatively correlated with LVEF (r =− 0.107, p =0.011). In multivariate linear regression analysis, VFA was the strongest independent determinant of LVMI (β =0.04, p =0.016), LVEF (β =− 0.01, p =0.023), and left atrial diameter (β =0.035, p < 0.0001), Internal diameter of the aortic root (β =0.014, p < 0.0001) and LvSd (β =0.017, p < 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.
Keywords: cardiac hemodynamics, left ventricular mass index, type 2 diabetes mellitus, visceral fat area