Skeletal muscle mass to visceral fat area ratio is an important determinant associated with type 2 diabetes and metabolic syndrome

Abstract

Background

Skeletal muscle mass to visceral fat area ratio (SVR) were shown to be related to some chronic diseases, such as non-alcoholic fatty liver diseases. The aim of this study is to determine whether the SVR is associated with metabolic syndrome (MS) and type 2 diabetes (T2DM).

Methods

A total of 798 subjects were included in this cross-sectional study. Lipid profiles, plasma glucose, blood pressure, waist circumference (WC) and body mass index (BMI) were grouped by the SVR. The associations between the SVR and T2DM and MS were examined using logistic regression to determine whether the SVR was associated with T2DM and MS.

Results

Lipid profiles, glucose levels, blood pressure, WC and BMI showed significant differences when stratified based on the extent of SVR. The SVR levels were also significantly higher in subjects without MS or T2DM than in those with MS or T2DM. The SVR was inversely correlated with lipid profiles and WC and was especially correlated with BMI, with an r>0.5. The SVR was identified as a risk factor for T2DM and MS after adjusting age and sex. SVR can predict T2DM [area under the curve =0.726, 95% CI (0.669–0.782), p<0.001] and MS [area under the curve =0.730, 95% CI (0.694–0.766), p<0.001]. The suitable cut-off value is 0.230 for T2DM (sensitivity 0.696, specificity 0.694) and 0.278 for the onset of MS (sensitivity 0.518, specificity 0.862).

Conclusion

The SVR is closely associated with an increased risk for exacerbating T2DM and MS and can be used as a diagnostic indicator for T2DM and MS.

Keywords:

• metabolic syndrome
• diabetes mellitus
• skeletal muscle mass
• visceral fat area

Acknowledgment

The authors express their gratitude to the TIDE study group, which was hold by the department of Endocrinology and Metabolism of the first affiliated hospital of China Medical University. This work was supported by grants from National Key Research and Development Program of China (2017YFC1309800 and 2017YFC0909600), The Clinical Research Fund of Chinese Medical Association (15010010589), The Research Fund for Public Welfare, National Health and Family Planning (201402005), Key Research and Department of Shandong Province (2016GSF201013), Key Research and Department of Shandong Province (2016GSF201015), Key Research and Department of Shandong Province (2017GSF18184, 2017GSF18129), National Major Scientific and Technological Special Project for “Significant New Drugs Development” (2015ZX0910019), Jinan Science and Technology Program (201704111), Natural science foundation of shandong province (ZR2019MH061).

Abbreviations

MS, metabolic syndrome; DM, diabetes; T2DM, Type 2 diabetes; SVR, skeletal muscle mass to visceral fat area ratio; CVD, cardiovascular disease; BMI, body mass index; WC, waist circumference; FPG, fasting plasm glucose; 2h-PG, 2h-plasm glucose; VFA, visceral fat area; CT, computed tomography; SBP, systolic blood pressure; DBP, diastolic blood pressure; OR, odds ratios; CI, confidence interval; AUC, area under the curve; ROC, receiver operating characteristic.

Ethics approval and consent to participate

The study protocol was approved by the ethics committee of China Medical University. Written informed consent was obtained from all participants following a detailed description of the purpose of the study. This study was conducted in accordance with the Declaration of Helsinki.

Consent for publication

All authors have read and approved the submission of the manuscript; the manuscript has not been published and is not being considered for publication elsewhere.

Author contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.