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KMID : 0388120030120020093
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Journal of Korean Society for the Study of Obesity
2003 Volume.12 No. 2 p.93 ~ p.107
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Relationship Between Obesity Indices and Risk Factors of Atherosclerosis in Type 2 Diabetics
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Jung Byung-Chun
Kim Bo-Wan
Park Soon-Hong
Lee Ju-Young
Lee Sin-Won
Chung Sung-Chang
Kim Jung-Guk
Ha Sung-Woo
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Abstract
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Background: Obesity is the powerful risk factor for type 2 diabetes and also associated with a significantly increased risk of insulin resistance, dyslipidemia, hypertension and atherosclerosis. Although obese individuals have these diseases, the relationship between obesity and these diseases was not certain until regional fat distribution was taken into account. Reports about the relationship between obesity and the risk factors of atherosclerosis in type 2 diabetics in Korea are very rare. To evaluate the relative importance of anthropometric indices on the development of atherosclerosis and obesity-related metabolic and vascular complications, the correlations of these indices with the risk factors for atherosclerosis were studied.
Methods: Patients with type 2 diabetes mellitus (n=425, male 196, female 229) who not used antihy- pertensives or anti-lipidemic agents were investigated. Body mass index (BMI) and percentage of body fat (%BF) estimated by skinfold-thickness in assessing generalized adiposity, and waist circumference (Wc) and waist-to-hip ratio (WHR) in assessing visceral adiposity were taken as anthropometric indices. We included the indicators of glycemic control (fasting blood sugar and HbAlc), insulin resistance (fasting serum insulin and C-peptide concentrations), lipid abnormalities (serum total cholesterol, triglyceride, HDL-cholesterol, and LDL-cholesterol concentrations), and systolic and diastolic blood pressure as risk factors for the development of atherosclerosis. Partial correlations of the anthropometric indices with those risk factors were investigated with adjustment of age and duration of illness.
Results: 1. BMI and %BF in female patients group were higher than those in male (24.2 vs 23.0 kg/㎡, 23.8 vs 13.5%, respectively, p<0.01 in all) although Wc and WHR were similar between both groups. In general, both body adiposity and abdominal obesity in them were much lower than in the Western.
2. Serum insulin and C-peptide levels were positively correlated with BMI, %BF, Wc and WHR (r=0.21~42, p<0.05 in all).
3. Serum total cholesterol, triglyceride and LDL- cholesterol were not correlated with any anthropometric indices. A weak negative correlation of serum HDL-cholesterol with these indices was found in male patients group.
4. Both systolic and diastolic blood pressures were positively correlated with all these indices only in male group (r=0.21~33, p<0.05 in all).
Conclusion: These results suggested that the severity of both generalized and visceral adiposity in these patients with type 2 diabetes mellitus were only mild but adiposity with abdominal distribution of body fat in diabetes mellitus could be a significant risk factor of developing atherosclerosis. In clinical practice, these anthropometric indices indicating general adiposity and abdominal obesity may provide useful information for predicting disease risks, especially of diabetes and cardio- vascular disease indirectly.
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KEYWORD
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Obesity indices, Adiposity, Atherosclerosis, Type 2 diabetes millitus
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