scholarly journals Assessment of obesity and visceral fat in diabetic nephropathy patients

2019 ◽  
Vol 7 (1) ◽  
pp. 72 ◽  
Author(s):  
Kumar Prafull Chandra ◽  
Balaji D. More ◽  
Anju B. More

Background: Diabetic nephropathy is one of the most common diabetic microvascular complication that typically develops after 10 years of diabetes diagnosis. The primary aim of this study was to evaluate the prevalence of obesity and visceral fat in Type 2 Diabetes (T2D) cases with nephropathy and without-nephropathy complication.Methods: In this cross-sectional study, diabetic nephropathy was diagnosed on the basis of biochemical tests of urine albumin, serum creatinine, eGFR, BP, and clinical assessment in patients with T2D. The prevalence of diabetic nephropathy estimated and the association between adiposity and diabetic nephropathy in patients T2D was evaluated. Measures of adiposity included body weight, Body Mass Index (BMI), Waist Circumference (WC), body fat percentage, muscle mass percentage and visceral fat percentage. Analysis of variance indicate difference in the various fat analysis parameters in presence and absence of nephropathy. PROC GLM procedure in the SAS Software was used for statistical calculations.Results: A total of 247 patients with type 2 diabetes (mean age 53.46±11.62 years; 39.5% females) were enrolled in this study. The participants were grouped as with Diabetic Nephropathy (DN) 41.60% (N=99) and without Diabetic Nephropathy (NDN) 58.40% (N=139). The comparison of DN and Non-DN groups showed no significant difference in the BMI, body and visceral fat, muscle mass percentage. Conclusions: Irrespective of the nephropathy status the body fat and visceral fat percentage is increased, and the muscle mass percentage is decreased in diabetes patients. As both obesity and diabetes contribute to the development and progression of renal disease, measures should to taken to reduce the body fat.

2015 ◽  
Vol 129 (12) ◽  
pp. 1083-1096 ◽  
Author(s):  
Joseph B. McPhee ◽  
Jonathan D. Schertzer

The bacteria that inhabit us have emerged as factors linking immunity and metabolism. Changes in our microbiota can modify obesity and the immune underpinnings of metabolic diseases such as Type 2 diabetes. Obesity coincides with a low-level systemic inflammation, which also manifests within metabolic tissues such as adipose tissue and liver. This metabolic inflammation can promote insulin resistance and dysglycaemia. However, the obesity and metabolic disease-related immune responses that are compartmentalized in the intestinal environment do not necessarily parallel the inflammatory status of metabolic tissues that control blood glucose. In fact, a permissive immune environment in the gut can exacerbate metabolic tissue inflammation. Unravelling these discordant immune responses in different parts of the body and establishing a connection between nutrients, immunity and the microbiota in the gut is a complex challenge. Recent evidence positions the relationship between host gut barrier function, intestinal T cell responses and specific microbes at the crossroads of obesity and inflammation in metabolic disease. A key problem to be addressed is understanding how metabolite, immune or bacterial signals from the gut are relayed and transferred into systemic or metabolic tissue inflammation that can impair insulin action preceding Type 2 diabetes.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kerry J Stewart ◽  
Brian H George ◽  
Kristina Potrekus ◽  
Anita C Bacher ◽  
Harry A Silber ◽  
...  

Background: Large artery stiffness, thought to be a marker of cardiovascular disease, is accelerated in persons with diabetes and hypertension. While reduced fatness and increased fitness are associated with lower BP, we tested the hypothesis that increased fatness and reduced fitness are each independently associated with greater aortic stiffness. Methods: Sedentary subjects (M=60; F=29), mean (SD) age 57.1 (5.8) years, were examined at baseline as part of an exercise training study to reduce BP in persons with type 2 diabetes. Subjects were taking their usual medical therapy. For BP eligibility, subjects were required to have SBP between 120–159 and/or DBP between 80–99 mm Hg during 2 consecutive weekly visits. BP was the mean of the screening visits and a visit after qualification for the study. Aortic stiffness was assessed by carotid-to-femoral pulse wave velocity (PWV), using ultrasound probes simultaneously at each of these sites. General fatness was assessed by dual-energy x-ray absorptiometry (DEXA) and expressed as percent body fat. Abdominal fatness was assessed by magnetic resonance imaging at the level of the umbilicus and the areas for total, subcutaneous, and visceral fat were measured. Maximal oxygen uptake was obtained on a treadmill. The associations of PWV with BP, oxygen uptake, and abdominal fat were determined by stepwise regression analysis with adjustment for age and gender. Results: PWV was 922.9 (300.0) msec, SBP was 126.9 (13.2) mm Hg, DBP was 71.8 (8.8) mm Hg, pulse pressure (PP) was 55.0 (10.4) mm Hg, percent body fat was 35.0 (6.5) %, and maximal oxygen uptake was 21.7 (5.0) ml/kg/min. In the final model, the variance in PWV was accounted for by increased PP, 8.9%; increased abdominal visceral fat accounted for an additional 6.2%; increased percent body fat, an additional 3%; and decreased maximal oxygen uptake, an additional 5.6%. Conclusions: These data bring to light an independent relationship of aortic stiffness with increased fatness and reduced fitness. Though further work is needed to elucidate the mechanisms linking aortic stiffness, fatness, and fitness, these findings support the need for a therapeutic approach for reducing aortic stiffness that considers the potential benefits of weight reduction and exercise.


2021 ◽  
pp. 55-59
Author(s):  
Lakshmi G.L ◽  
Shruti Dasgupta ◽  
Mohammed Salman ◽  
Sanjay K. R

Background: Ghrelin and leptin are the key hormones involved in the energy homeostasis and plays a relevant role in regulating hunger and satiety stimuli afferent to the brain. Abnormalities in the levels of ghrelin and leptin are often associated with the obesity and type 2 diabetes complications. However, there are no studies clarifying whether ghrelin and leptin levels have stronger association with obesity or Type 2 diabetes (T2DM). Aims:To evaluate and compare the independent effect of major dening factors of obesity and diabetes on ghrelin and leptin concentrations. Materials And Methods: Anthropometric measures such as height, weight, waist (WC) and hip circumference (HC), Body mass index (BMI), Basal metabolic rate (BMR), fat percentage, lean body mass, were taken. Assessed daily physical activity and energy intake. Biochemical parameters such as fasting glucose, postprandial glucose, HBA1c, ghrelin, leptin and insulin levels were measured. Statistical Analysis: One-way analysis of variance (ANOVA), Chi-square (χ2) test Pearson's correlation coefcients, Multiple stepwise linear regression model analysis were performed. Result: The diabetic subjects irrespective of obesity showed signicantly higher waist to hip ratio, HOMAIR levels of fasting blood glucose, postprandial glucose and signicantly lower levels of Ghrelin than non-diabetics. Similarly, obese subjects irrespective of diabetes have signicantly higher BMR and higher levels of Leptin than non-diabetics. Asignicantly higher BMI, fat mass percentage and lower lean body mass percentage were observed in obese subjects irrespective of diabetes than non-obese subjects. Among non-obese, diabetics have higher BMI, Fat mass percentage and lower lean body mass percentage. The levels of insulin were signicantly higher in diabetic obese subjects. HOMAIR (P≤0.0001) and Postprandial glucose (P≤0.05) showed negative independent effect and QUICKI (P≤0.0001) showed positive independent effect on the levels of ghrelin. BMI (P≤0.05) showed a positive effect and lean body mass percentage (P≤0.0001) showed an inverse effect on levels of leptin. Conclusion: It is evident from the study that low levels of ghrelin are predominantly associated with diabetes parameters when compared to parameters of obesity and on the contrary increased leptin levels have much stronger association with measures of obesity than diabetes. Evidence of altered leptin and ghrelin levels in these disorders infers vice versa, their respective roles in obesity and lean diabetes.


2020 ◽  
Author(s):  
Xia Sun ◽  
Liping Chen ◽  
Rongzhen Wu ◽  
Dan Zhang ◽  
Yinhui He

Abstract Background: This study compared the relationship between thyroid hormones and lipid metabolism/body fat content in euthyroid male patients with type 2 diabetes mellitus (T2DM) in China. Methods: A total of 64 male patients who were diagnosed as T2DM and 64 non-diabetic males who underwent health examination were matched according to age at a 1:1 ratio. Results: The 32 subjects in each sub-group showed differences in age, body mass index (BMI), mean arterial pressure, waist circumference, visceral fat content, body fat percentage, HbA1c, HOMA-IR, FT3, TSH, HDL-c, adiponectin, leptin, visfatin and TNF-α (all P < 0.05). In the overall population, FT3 was positively correlated with body fat percentage (r=0.21, P=0.02), and negatively correlated with HOMA-IR (r=-0.18, P=0.04) and visfatin (r=-0.47, P <0.01); TSH was positively correlated with body fat percentage (r=0.23, P=0.01). In the T2DM-OB group FT3 was positively correlated with BMI (r=0.45, P <0.05), visceral fat content (r=0.50, P <0.05), and body fat percentage (r=0.44, P <0.05); FT4 was positively correlated with visceral fat content (r=0.38, P <0.05); and TSH was positively correlated with HOMA-IR (r=0.39, P <0.05). Conclusion: TSH increased in obese people and FT3 was lower in patients with T2DM.


2020 ◽  
Vol 51 (6) ◽  
pp. 564-571 ◽  
Author(s):  
Jorge Escobedo-de la Peña ◽  
Jorge Alejandro Ramírez-Hernández ◽  
María Teresa Fernández-Ramos ◽  
Evangelina González-Figueroa ◽  
Beatriz Champagne

2019 ◽  
Vol 23 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Andrea Ruiz-Alejos ◽  
Rodrigo M Carrillo-Larco ◽  
J Jaime Miranda ◽  
Robert H Gilman ◽  
Liam Smeeth ◽  
...  

AbstractObjective:To determine the association between excess body fat, assessed by skinfold thickness, and the incidence of type 2 diabetes mellitus (T2DM) and hypertension (HT).Design:Data from the ongoing PERU MIGRANT Study were analysed. The outcomes were T2DM and HT, and the exposure was skinfold thickness measured in bicipital, tricipital, subscapular and suprailiac areas. The Durnin–Womersley formula and SIRI equation were used for body fat percentage estimation. Risk ratios and population attributable fractions (PAF) were calculated using Poisson regression.Setting:Rural (Ayacucho) and urban shantytown district (San Juan de Miraflores, Lima) in Peru.Participants:Adults (n 988) aged ≥30 years (rural, rural-to-urban migrants, urban) completed the baseline study. A total of 785 and 690 were included in T2DM and HT incidence analysis, respectively.Results:At baseline, age mean was 48·0 (sd 12·0) years and 47 % were males. For T2DM, in 7·6 (sd 1·3) years, sixty-one new cases were identified, overall incidence of 1·0 (95 % CI 0·8, 1·3) per 100 person-years. Bicipital and subscapular skinfolds were associated with 2·8-fold and 6·4-fold risk of developing T2DM. On the other hand, in 6·5 (sd 2·5) years, overall incidence of HT was 2·6 (95 % CI 2·2, 3·1) per 100 person-years. Subscapular and overall fat obesity were associated with 2·4- and 2·9-fold risk for developing HT. The PAF for subscapular skinfold was 73·6 and 39·2 % for T2DM and HT, respectively.Conclusions:We found a strong association between subscapular skinfold thickness and developing T2DM and HT. Skinfold assessment can be a laboratory-free strategy to identify high-risk HT and T2DM cases.


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