PMID- 37308932 OWN - NLM STAT- MEDLINE DCOM- 20230614 LR - 20230624 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 22 IP - 1 DP - 2023 Jun 12 TI - Normal-weight visceral obesity promotes a higher 10-year atherosclerotic cardiovascular disease risk in patients with type 2 diabetes mellitus-a multicenter study in China. PG - 137 LID - 10.1186/s12933-023-01876-7 [doi] LID - 137 AB - BACKGROUND: Visceral obesity is associated with high cardiovascular events risk in type 2 diabetes mellitus (T2DM). Whether normal-weight visceral obesity will pose a higher atherosclerotic cardiovascular disease (ASCVD) risk than body mass index (BMI)-defined overweight or obese counterparts with or without visceral obesity remains unclear. We aimed to explore the relationship between general obesity and visceral obesity and 10-year ASCVD risk in patients with T2DM. METHODS: Patients with T2DM (6997) who satisfied the requirements for inclusion were enrolled. Patients were considered to have normal weight when 18.5 kg/m(2) /= 28 kg/m(2). Visceral obesity was defined as a visceral fat area (VFA) >/= 100 cm(2). Patients were separated into six groups based on BMI and VFA. The odd ratios (OR) for a high 10-year ASCVD risk for different combinations of BMI and VFA were analysed using stepwise logistic regression. Receiver operating characteristic (ROC) curves for diagnosing the high 10-year ASCVD risk were constructed, and areas under the ROC curves were estimated. Potential non-linear relationships between VFA levels and high 10-year ASCVD risk were examined using restricted cubic splines (knot = 4). Multilinear regression was used to identify factors affecting VFA in patients with T2DM. RESULTS: In patients with T2DM, subjects with normal-weight visceral obesity had the highest 10-year ASCVD risk among the six groups, which had more than a 2-fold or 3-fold higher OR than those who were overweight or obese according to BMI but did not have visceral obesity (all P < 0.05). The VFA threshold for high 10-year ASCVD risk was 90 cm(2). Multilinear regression showed significant differences in the effect of age, hypertension, drinking, fasting serum insulin, fasting plasma glucose, 2 h postprandial C-peptide, triglyceride, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol on VFA in patients with T2DM (all P < 0.05). CONCLUSIONS: T2DM patients with normal-weight visceral obesity had a higher 10-year ASCVD risk than BMI-defined overweight or obese counterparts with or without visceral obesity, which should initiate standardised management for ASCVD primary prevention. CI - (c) 2023. The Author(s). FAU - Zheng, Jia AU - Zheng J AD - Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China. FAU - Hu, Ye AU - Hu Y AD - Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China. FAU - Xu, Hanwen AU - Xu H AD - Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China. FAU - Lei, Yu AU - Lei Y AD - Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China. FAU - Zhang, Jieji AU - Zhang J AD - Department of Endocrinology, Fenghua District Traditional Chinese Medicine Hospital of Ningbo, Ningbo, 315500, China. FAU - Zheng, Qidong AU - Zheng Q AD - Department of Endocrinology, Yuhuan Second People's Hospital, Taizhou, 317605, China. FAU - Li, Li AU - Li L AD - Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, 315000, China. FAU - Tu, Weiping AU - Tu W AD - Department of Endocrinology, Shaoxing Shangyu People's Hospital, Shaoxing, 312300, China. FAU - Chen, Riqiu AU - Chen R AD - Department of Endocrinology, Lishui People's Hospital, Lishui, 323000, China. FAU - Guo, Qiongyao AU - Guo Q AD - Department of Endocrinology, The People's Hospital of Putuo Zhoushan, Zhoushan, 316100, China. FAU - Zang, Xunxiong AU - Zang X AD - Department of Endocrinology, Yueqing People's Hospital, Wenzhou, 325600, China. FAU - You, Qiaoying AU - You Q AD - Department of Endocrine and Metabolism, Shaoxing People's Hospital, Shaoxing, 312000, China. FAU - Xu, Zhiyong AU - Xu Z AD - Department of Endocrinology, Xianju people's hospital, Taizhou, 317300, China. FAU - Zhou, Qiang AU - Zhou Q AD - Department of Endocrinology, The First Hospital of Jiaxing, Jiaxing, 314000, China. FAU - Wu, Xiaohong AU - Wu X AUID- ORCID: 0000-0001-5984-3342 AD - Geriatric Medicine Center, Key Laboratory of Endocrine Gland Diseases of Zhejiang Province, Department of Endocrinology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, People's Republic of China. drxhwu@163.com. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20230612 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 RN - 0 (Cholesterol, HDL) SB - IM MH - Humans MH - Obesity, Abdominal MH - Overweight MH - *Cardiovascular Diseases MH - *Diabetes Mellitus, Type 2 MH - Obesity MH - China MH - *Atherosclerosis MH - Cholesterol, HDL PMC - PMC10262529 OTO - NOTNLM OT - Atherosclerotic cardiovascular disease risk OT - Multicentre study OT - Normal weight OT - Obesity paradox OT - Type 2 diabetes mellitus OT - Visceral obesity COIS- The authors declare no competing interests. EDAT- 2023/06/13 01:14 MHDA- 2023/06/14 06:42 PMCR- 2023/06/12 CRDT- 2023/06/12 23:40 PHST- 2023/04/05 00:00 [received] PHST- 2023/06/02 00:00 [accepted] PHST- 2023/06/14 06:42 [medline] PHST- 2023/06/13 01:14 [pubmed] PHST- 2023/06/12 23:40 [entrez] PHST- 2023/06/12 00:00 [pmc-release] AID - 10.1186/s12933-023-01876-7 [pii] AID - 1876 [pii] AID - 10.1186/s12933-023-01876-7 [doi] PST - epublish SO - Cardiovasc Diabetol. 2023 Jun 12;22(1):137. doi: 10.1186/s12933-023-01876-7.