Xuan Ma,1,2,* Xinghe Jiang,1,* Guanqi Gao,2 Bo Ban,3 Jie Sheng,1,2 Shuwei Shi,1,2 Hongyan Zhao,1,2 Baolan Ji2 

1School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, 261000, People’s Republic of China; 2Department of Endocrinology, Linyi People’s Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong, 276034, People’s Republic of China; 3Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Baolan Ji, Department of Endocrinology, Linyi People’s Hospital, North Side of the Intersection of Wohushan Road and Wuhan Road in Lanshan District, Linyi, Shandong, 276034, People’s Republic of China, Email jibaolan@yeah.net

Background: 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.
Methods: 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.
Results: 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).
Conclusion: 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.

Keywords: remnant cholesterol, type 2 diabetes mellitus, unconventional lipid profiles, visceral fat area, visceral fat obesity