A total of 470 patients were screened, and 445 patients meeting the inclusion and exclusion criteria were enrolled into this study, the flow diagram of excluded and included patients was present in Figure 2.Among the 445 patients, 226(50.7%) patients were man, the mean age of patients was 53.3±7.9 years, the mean PrFT of patients was 12.8±4.8mm. The prevalence of patients with MetS was 58.2%,57.5% in men and 58.9% in women separately. Due to the significant difference of mean PrFT between men and women(13.3±5.1mm vs 12.2±4.3mm,P<0.001), the characteristics of patients enrolled into this study were divided into three groups based on tertiles of PrFT in men and women. As shown in Table 1 and Table 2, there were significant difference in BMI, WC, TG, HDL-c, LDL-c, APOB, UA, SBP, DBP and HOMA-IR among groups in men and women (P<0.05). Patients in higher PrFT groups showed higher level of BMI, WC, TG, UA, SBP, DBP, HOMA-IR and lower level of HDL-c compared with lower PrFT groups in men and women (P<0.05). Moreover, patients in higher PrFT groups showed more patients had MetS and hypertension both in men and women(P<0.05).
Table 1
Characteristics of patients with Newly-Diagnosed T2DM were divided into three groups based on tertiles of PrFT in man.
| Total | T1 (<10.7mm) | T2 (10.7~16.1mm) | T3 (>16.1mm) | P |
Age(year) | 52.5±8.2 | 52.4±8.9 | 52.3±7.7 | 52.8±8.1 | 0.618 |
WC(cm) | 86.6±7.0 | 80.3±3.3 | 86.9±4.8ab | 92.4±6.4bc | <0.001 |
BMI(kg/m2) | 24.8±3.1 | 22.0±1.9 | 25.0±1.9ab | 27.2±2.9bc | <0.001 |
HbA1c(%) | 8.8±0.9 | 8.8±1.0 | 8.7±0.8 | 8.9±0.9 | 0.327 |
TG(mmol/L) | 2.3±1.5 | 1.5±1.0 | 2.0±0.7ab | 3.3±1.9bc | <0.001 |
TC(mmol/L) | 5.4±1.3 | 5.1±1.1 | 5.5±1.4a | 5.6±1.2b | 0.026 |
HDL-c(mmol/L) | 1.1±0.2 | 1.3±0.2 | 1.1±0.1ab | 0.9±0.1bc | <0.001 |
LDL-c(mmol/L) | 3.6±1.0 | 3.4±0.9 | 3.8±1.1a | 3.7±0.9b | 0.014 |
APOA(g/L) | 1.3±0.3 | 1.4±0.2 | 1.3±0.2a | 1.2±0.3b | 0.003 |
APOB(g/L) | 1.1±0.3 | 1.0±0.3 | 1.1±0.3a | 1.1±0.3b | 0.018 |
UA(umol/L) | 360.4±86.2 | 307.5±60.1 | 372.4±77.2ab | 401.4±90.5bc | <0.001 |
SBP(mmHg) | 134.3±18.4 | 119.1±11.4 | 137.2±10.2ab | 146.1±19.4bc | <0.001 |
DBP(mmHg) | 82.5±10.3 | 76.6±6.1 | 83.4±12.2ab | 87.5±7.2bc | <0.001 |
HOMA-IR | 11.5±6.5 | 6.3±3.7 | 12.4±4.7ab | 15.6±6.8bc | <0.001 |
hs-CRP(mg/L) | 3.4±1.1 | 3.3±0.9 | 3.4±1.0 | 3.5±0.9 | 0.218 |
Hypertension, n(%) | 84(37.2) | 9(12.0) | 27(36.5)ab | 48(62.3)bc | <0.001 |
Smoking, n(%) | 120(53.1) | 38(50.7) | 40(54.1) | 42(54.5) | 0.683 |
MetS, n(%) | 130(57.5) | 11(14.7) | 24(32.4)ab | 69(89.6)bc | <0.001 |
BMI: body mass index; WC: waist circumference. HbA1c: Glycated hemoglobin. UA: uric acid. TG: triglyceride. TC: total cholesterol. HDL-c: high-density lipoprotein cholesterol. LDL-c: Low density lipoprotein cholesterol. SBP: Systolic blood pressure. DBP: Diastolic blood pressure. HOMR-IR: Homeostasis model assessment insulin resistance. hs-CRP: High sensitivity C-reactive protein; MetS: Metabolic syndrome. aP<0.05: T1 vs T2. bP<0.05: T1 vs T3. cP<0.05: T2 vsT3. |
Table 2
Characteristics of patients with Newly-Diagnosed T2DM were divided into three groups based on tertiles of PrFT in women.
| Total | T1 (<10.2mm) | T2 (10.2~14.9mm) | T3 (>14.9mm) | P |
Age(year) | 54.2±7.5 | 53.5±7.7 | 54.1±7.5 | 54.8±7.3 | 0.569 |
WC(cm) | 85.1±6.7 | 80.4±3.8 | 84.6±5.0ab | 90.2±6.8bc | <0.001 |
BMI(kg/m2) | 24.2±2.9 | 22.1±2.1 | 24.1±2.2ab | 26.3±2.6bc | <0.001 |
HbA1c(%) | 8.7±1.0 | 8.7±1.1 | 8.8±0.9 | 8.7±1.0 | 0.624 |
TG(mmol/L) | 2.0±1.1 | 1.3±0.5 | 1.8±0.6ab | 2.9±1.3bc | <0.001 |
TC(mmol/L) | 5.1±1.1 | 4.9±1.1 | 5.2±1.2 | 5.2±1.0b | 0.089 |
HDL-c(mmol/L) | 1.1±0.2 | 1.3±0.2 | 1.1±0.2ab | 0.9±0.2bc | <0.001 |
LDL-c(mmol/L) | 3.4±0.9 | 3.1±0.8 | 3.6±0.9a | 3.5±1.0b | 0.001 |
APOA(g/L) | 1.3±0.3 | 1.3±0.3 | 1.3±0.2 | 1.2±0.3 | 0.519 |
APOB(g/L) | 1.0±0.3 | 0.9±0.3 | 1.0±0.3a | 1.0±0.3b | 0.001 |
UA(umol/L) | 348.9±86.8 | 281.8±62.3 | 352.5±66.3ab | 411.5±76.8bc | <0.001 |
SBP(mmHg) | 132.3±16.6 | 119.5±12.2 | 132.6±16.6ab | 144.6±9.7bc | <0.001 |
DBP(mmHg) | 81.0±88.0 | 74.6±5.7 | 82.0±9.4ab | 86.5±6.5bc | <0.001 |
HOMA-IR | 10.7±5.4 | 6.5±3.7 | 11.4±4.3ab | 14.0±5.1bc | <0.001 |
hs-CRP(mg/L) | 2.9±0.8 | 3.0±0.9 | 2.8±1.2 | 2.8±0.9 | 0.692 |
Hypertension, n(%) | 81(37.0) | 11(15.1) | 24(33.3)ab | 46(62.2)bc | <0.001 |
Smoking, n(%) | 6(2.7) | 3(4.1) | 3(4.2) | 0(0) | 0.207 |
MetS, n(%) | 129(58.9) | 9(12.3) | 50(69.4)ab | 70(94.6)bc | <0.001 |
BMI: body mass index; WC: waist circumference. HbA1c: Glycated hemoglobin. UA: uric acid. TG: triglyceride. TC: total cholesterol. HDL-c: high-density lipoprotein cholesterol. LDL-c: Low density lipoprotein cholesterol. SBP: Systolic blood pressure. DBP: Diastolic blood pressure. HOMR-IR: Homeostasis model assessment insulin resistance. hs-CRP: High sensitivity C-reactive protein; MetS: Metabolic syndrome. aP<0.05: T1 vs T2. bP<0.05: T1 vs T3. cP<0.05: T2 vsT3. |
The main correlations between metabolic parameters and PrFT in the subgroup divided by sex were presented in Table 3. The results showed that PrFT was significantly and positively correlated with WC (R= 0.770, P<0.001), BMI (R= 0.779, P<0.001), TG (R= 0.602, P<0.001), LDL-c (R= 0.156, P=0.019), UA (R= 0.494, P<0.001), SBP (R= 0.695, P<0.001), DBP (R= 0.538, P<0.001) and HOMA-IR (R= 0.688, P<0.001) in men group, and WC (R= 0.674, P<0.001), BMI (R= 0.690, P<0.001), TG (R= 0.726, P<0.001), LDL-c (R= 0.190, P=0.005), UA (R= 0.665, P<0.001), SBP (R= 0.713, P<0.001), DBP (R= 0.611, P<0.001) and HOMA-IR (R= 0.656, P<0.001) in women group. Moreover, PrFT was significantly and negatively correlated with HDL-c (R= -0.592, P<0.001) in men group and HDL-c (R= -0.507, P<0.001) in women group.
Table 3
Main correlations between metabolic parameters and PrFT in patients with Newly-Diagnosed T2DM divided by sex.
Parameter | Men(n=226) | Women(n=219) |
R | P | R | P |
WC(cm) | 0.770 | <0.001 | 0.674 | <0.001 |
BMI(kg/m2) | 0.779 | <0.001 | 0.690 | <0.001 |
TG(mmol/L) | 0.602 | <0.001 | 0.726 | <0.001 |
TC(mmol/L) | 0.128 | 0.068 | 0.131 | 0.051 |
LDL-c(mmol/L) | 0.156 | 0.019 | 0.190 | 0.005 |
HDL-c(mmol/L) | -0.592 | <0.001 | -0.507 | <0.001 |
UA(umol/L) | 0.494 | <0.001 | 0.665 | <0.001 |
SBP(mmHg) | 0.695 | <0.001 | 0.713 | <0.001 |
DBP(mmHg) | 0.538 | <0.001 | 0.611 | <0.001 |
HOMA-IR | 0.688 | <0.001 | 0.656 | <0.001 |
BMI: body mass index; WC: waist circumference.TG: triglyceride; TC: total cholesterol. HDL-c: high-density lipoprotein cholesterol. LDL-c: Low density lipoprotein cholesterol. UA: uric acid. SBP: Systolic blood pressure. DBP: Diastolic blood pressure. HOMR-IR: Homeostasis model assessment insulin resistance. |
The associations between MetS and PrFT were further investigated by binomial logistic regression analysis in patients with Newly-Diagnosed T2DM divided by sex (Table 4). The PrFT was shown to be independently associated with MetS after adjustment for Age, HbA1c and Smoking (Model 1), the ORs(95%CI) were 1.53(1.38~1.70) in men and 1.66(1.47~1.88) in women. After further adjustment for BMI, TC, LDL-c, APOA, APOB, UA, HOMA-IR, and hs-CRP (Model 2), the PrFT was shown to be independently associated with MetS, the ORs(95%CI) were 1.32(1.13~1.54) in men and 1.53(1.27~1.83) in women. After further additional adjustment for TG, WC, HDL-c, SBP and DBP (Model 3), the ORs did not substantially change, the ORs(95%CI) were 1.33(1.01~1.74) in men and 1.53(1.08~2.17) in women(P<0.05).
Table 4
Binomial Logistic Regression Analysis adjusted ORs (95% CIs) of PrFT in patients with Newly-Diagnosed T2DM divided by sex.
Parameter | Men(n=226) | Women(n=219) |
OR(95%CI) | P | OR(95%CI) | P |
Model 1 | 1.53(1.38~1.70) | <0.001 | 1.66(1.47~1.88) | <0.001 |
Model 2 | 1.32(1.13~1.54) | <0.001 | 1.53(1.27~1.83) | <0.001 |
Model 3 | 1.33(1.01~1.74) | 0.043 | 1.53(1.08~2.17) | 0.017 |
Model 1: adjusted for Age, HbA1c and Smoking. Model 2: adjusted for BMI, TC, LDL-C, APOA, APOB, UA, HOMA-IR, and hs-CRP. Model 3: additional adjusted for TG, WC, HDL-c, SBP and DBP. BMI: body mass index; WC: waist circumference. HbA1c: Glycated hemoglobin. UA: uric acid. TG: triglyceride. TC: total cholesterol. HDL-c: high-density lipoprotein cholesterol. LDL-c: Low density lipoprotein cholesterol. SBP: Systolic blood pressure. DBP: Diastolic blood pressure. HOMR-IR: Homeostasis model assessment insulin resistance. hs-CRP: High sensitivity C-reactive protein; MetS: Metabolic syndrome. |
The ROC curve analysis was used to further analyzing the predicting value of PrFT for MetS in patients with Newly-Diagnosed T2DM divided by sex. From the ROC curve analysis, the results showed a good predictive value of PrFT for MetS, the areas under the curve of ROC values of PrFT predicting MetS were 0.895(95% CI 0.852~0.939, P<0.001) in men and 0.910(95% CI 0.876~0.953, P<0.001) in women (Figure 3). The optimal cut-off values of PrFT were 14.6 mm (sensitivity: 83.8%, specificity: 89.6%) for men and 13.1 mm (sensitivity: 87.6%, specificity: 91.1%) for women (Table 5).
Table 5
ROC Curve Analysis of PrFT in Predicting MetS in patients with Newly-Diagnosed T2DM divided by sex.
Variables | AUC(95% CI) | Cut-Off value | Sensitivity (%) | Specificity (%) |
Men(n=226) |
PrFT | 0.895(0.852~0.939) | 14.6 | 83.8 | 89.6 |
Women(n=219) |
PrFT | 0.910(0.876~0.953) | 13.1 | 87.6 | 91.1 |
MetS: Metabolic syndrome. PrFT: Perirenal fat thickness. |