Diabetes & Metabolism Journal

Original Articles

The Correlation between Central Obesity and Glucose, Lipid Metabolism and Macrovascular Complication in Elderly Type 2 Diabetes.: Eui Dal Jung, Jihyun Lee, Ho Sang Shon; Korean Diabetes J. 2007;31(4):343-350. Published online July 1, 2007; DOI: https://doi.org/10.4093/jkda.2007.31.4.343

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BACKGROUND
Obesity is related to abnormal lipid metabolism and macrovascular complication and accumulated fat on the abdomen in elderly diabetic patients. The aim of this study was to compare elderly diabetic patients' body fat composition with middle-aged patients and evaluate the role of central obesity on glucose and lipid metabolism and macrovascular complications in elderly type 2 diabetic patients. METHODS: We defined elderly patients who are over 65 years old and who waist circumference is over than 90 cm in men and 85 cm in women and waist-hip ratio (WHR) was over than 0.90 in men and 0.85 in women defined central obesity. % body fat were measured a bioimpedence analysis using DSM (Direct Segmental Measurement by 8-point electrode) method (Inbody 3.0, Biospace, Seoul, Korea) in two hundred two type 2 diabetes. Laboratory parameters such as fasting blood glucose, HbA1c, and lipid profile were included in this study and also investigated the macrovascular complication. RESULTS: 1) The ninety-five elderly diabetic patients, compared with middle-aged diabetic patients, were similar BMI and % of body fat but significantly increased waist circumference (P < 0.05) and WHR (P < 0.001). 2) In pearson's correlations, waist circumference was correlated with BMI (r = 0.927, P < 0.001), WHR (r = 0.851, P < 0.001), % body fat (r = 0.519, P < 0.001), total cholesterol (r = 0.255, P < 0.05), triglyceride (r = 0.365, P < 0.001), and LDL-cholesterol (r = 0.271, P < 0.05) in elderly diabetic patients. And WHR was also correlated with BMI (r = 0.744, P < 0.001), waist circumference (r = 0.851, P < 0.001), % body fat (r = 0.425, P < 0.001), total cholesterol (r = 0.372, P < 0.001), triglyceride (r = 0.408, P < 0.001), and LDL-cholesterol (r = 0.386, P < 0.001). 3) The obese elderly diabetic patients had increased triglyceride, total cholesterol and LDL-cholesterol but not related with macrovascular complication compared with lean elderly patients. CONCLUSION: In elderly type 2 diabetic patients are more central obesity although the same weight compared with middle-aged patients. Waist circumference and WHR were highly correlated with body fat composition and lipid profile in elderly diabetes. In obese elderly patients have abnormal lipid profile but not more macrovascular complication.

Citations

Citations to this article as recorded by

Potential Benefits of Acupuncture and Herbs for Obesity‐Related Chronic Inflammation by Adipokines
Ji-Youn Kim, Seon-Eun Baek, Rehna Paula Ginting, Min-Woo Lee, Jeong-Eun Yoo, Yuan Xu
Evidence-Based Complementary and Alternative Medicine.2020;[Epub] CrossRef
A Nationwide Survey about the Current Status of Glycemic Control and Complications in Diabetic Patients in 2006 - The Committee of the Korean Diabetes Association on the Epidemiology of Diabetes Mellitus -
Soo Lim, Dae Jung Kim, In-Kyung Jeong, Hyun Shik Son, Choon Hee Chung, Gwanpyo Koh, Dae Ho Lee, Kyu Chang Won, Jeong Hyun Park, Tae Sun Park, Jihyun Ahn, Jaetaek Kim, Keun-Gyu Park, Seung Hyun Ko, Yu-Bae Ahn, Inkyu Lee
Korean Diabetes Journal.2009; 33(1): 48. CrossRef

Normative Data of Intima-medial Thickness in Korean Adults and the Estimation of the Relative Risk of Macrovascular Diseases Using this Data in Type 2 Diabetic Subjects.: H J Kim, Y J Won, D J Kim, C W Ahn, B S Cha, S K Lim, K R Kim, H C Lee, K B Huh; Korean Diabetes J. 2003;27(3):288-298. Published online June 1, 2003

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Abstract PDF: BACKGROUND
The reference values of the carotid mean intima-medial thickness (IMT), in subjects without diabetes or macrovascular diseases, were estimated, which were used to establish the relative risks of macrovascular diseases in type 2 diabetic subjects. METHODS: High resolution B-mode ultrasonography was performed in 1229 nondiabetic subjects, without ischemic heart disease, cerebral infarction or peripheral vascular disease, and in 830 type 2 diabetic subjects. The nondiabetic subjects were participating in medical checkups at the Health Promotion Center. The height, weight, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol and fasting insulin level were measured in all subjects. RESULTS: The nondiabetic subjects, without ischemic heart disease, cerebral infarction or peripheral arterial obstructive diseases, were classified by age (31~40, 41~50, 51~60, 61~70 and >70 years) and sex. There were significant differences between the diabetic and nondiabetic subjects in relation to the age groups, but no significant difference was found between the sexes. Independent risk factors associated with the carotid mean IMT in the nondiabetic subjects were age, systolic blood pressure and body mass index, and those in the diabetic subjects were age, duration of diabetes and a low density lipoprotein-cholesterol level. The relative risks of ischemic heart disease, cerebral infarction and peripheral vascular disease, due to the presence of an increased IMT, were 2.34 (CI; 1.32~4.14), 2.95 (CI; 1.57~5.54) and 3.64 (CI; 1.79~7.40) in the diabetic subjects. CONCLUSION: It was concluded that the reference values of the IMT, as classified by age, in the subjects without diabetes or macrovascular diseases, favorably reflected the risks of macrovascular diseases in the type 2 diabetic subjects

Urinary albumin excretion, von Willebrand factor and macrovascular disease in patients with NIDDM.: Sin Gon Kim, Soo Mi Kim, Dong Hyun Shin, Nan Hee Kim, Yoon Sang Choi, Ie Byung Park, Sei Hyun Baik, Dong Seop Choi; Korean Diabetes J. 1997;21(2):176-184. Published online January 1, 2001

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Abstract PDF: BACKGROUND
Increased urinary albumin excretion (UAE) is not only an independent predictor of progressive renal disease but also an important marker of atherosclerotic disease in patients with NIDDM. However, the pathaphysiologic basis of this observation is poorly understood. Recently, one interesting hypothesis suggested: UAE rnerely reflects a glomerular manifestation of an otherwise generalized vascular dysfunction(hyperpermeable state), and Stehouwer et al. Reported a strong relationship between plasma von Willebrand factor level(a measure of endothelial dysfunction), UAE and cardiovascular diseases. Therefore, we studied the relationship between UAE, plasma vWF and macrovascular disease in patients with NIDDM. METHODS: We measured UAE and plasma vWF levels in 102 patients with NIDDM, and investigated the telationship between these values and macrovascular diseses. Also, we assesed the risk factars for macrovascular disease. RESULTS: 1) Among total of 102 patients, nonnoalbuminuria, microalbuminuria and macroalbuminuria group were 58 patients(56.9%), 28 patients(27.5%) and 16 patients(15.6%), respectively. 2) The prevalencies of hypertension, diabetic retinopathy and macrovascular diseases were the highest in macroalbuminuria group, followed by microalbuminuria and norrnoalbuminuria group in order of frequency. 3) Plasma vWF and UAE levels were significantly correlated(r=0.44). 4) Plasma vWF concentrations were higher in patients with macrovascular diseases than in those without macrovascular diseases, and also higher in patients with retinopathy compared with those without retinopathy. 5) Multivariate logistic regression analysis showed that age, smoking and vWF were independent risk factors for macrovascular diseases. CONCLUSION: 1) As plasma vWF and UAE values were increased, more macrovascular diseases were observed in patients with NIDDM. 2) Plasma vWF may be used as an indicator of macrovascular disease in patients with NIDDM.

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