Tags

Type your tag names separated by a space and hit enter

Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study.
Cardiovasc Diabetol. 2018 04 10; 17(1):55.CD

Abstract

BACKGROUND

Sarcopenic obesity, defined as reduced skeletal muscle mass and power with increased adiposity, was reported to be associated with cardiovascular disease risks in previous cross-sectional studies. Whole body dual-energy X-ray absorptiometry (DXA) can simultaneously evaluate both fat and muscle mass, therefore, whole body DXA may be suitable for the diagnosis of sarcopenic obesity. However, little is known regarding whether sarcopenic obesity determined using whole body DXA could predict incident cardiovascular disease (CVD). The aim of this study was to investigate the impact of sarcopenic obesity on incident CVD in patients with type 2 diabetes.

METHODS

A total of 716 Japanese patients (mean age 65 ± 13 years; 47.0% female) were enrolled. Android fat mass (kg), gynoid fat mass (kg), and skeletal muscle index (SMI) calculated as appendicular non-fat mass (kg) divided by height squared (m2), were measured using whole body DXA. Sarcopenic obesity was defined as the coexistence of low SMI and obesity determined by four patterns of obesity as follows: android to gynoid ratio (A/G ratio), android fat mass or percentage of body fat (%BF) was higher than the sex-specific median, or body mass index (BMI) was equal to or greater than 25 kg/m2. The study endpoint was the first occurrence or recurrence of CVD.

RESULTS

Over a median follow up of 2.6 years (IQR 2.1-3.2 years), 53 patients reached the endpoint. Sarcopenic obesity was significantly associated with incident CVD even after adjustment for the confounding variables, when using A/G ratio [hazard ratio (HR) 2.63, 95% CI 1.10-6.28, p = 0.030] and android fat mass (HR 2.57, 95% CI 1.01-6.54, p = 0.048) to define obesity, but not %BF (HR 1.67, 95% CI 0.69-4.02, p = 0.252), and BMI (HR 1.55, 95% CI 0.44-5.49, p = 0.496).

CONCLUSIONS

The present data suggest that the whole body DXA is valuable in the diagnosis of sarcopenic obesity (high A/G ratio or android fat mass with low SMI) to determine the risk of CVD events in patients with type 2 diabetes. Meanwhile, sarcopenic obesity classified with low SMI, and high %BF or BMI was not associated with incident CVD.

Authors+Show Affiliations

Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. bouchi.mem@tmd.ac.jp. Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan. bouchi.mem@tmd.ac.jp. Diabetes and Metabolism Information Center, National Center for Global Health and Medicine, Tokyo, Japan. bouchi.mem@tmd.ac.jp.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Department of Molecular and Cellular Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29636045

Citation

Fukuda, Tatsuya, et al. "Sarcopenic Obesity Assessed Using Dual Energy X-ray Absorptiometry (DXA) Can Predict Cardiovascular Disease in Patients With Type 2 Diabetes: a Retrospective Observational Study." Cardiovascular Diabetology, vol. 17, no. 1, 2018, p. 55.
Fukuda T, Bouchi R, Takeuchi T, et al. Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study. Cardiovasc Diabetol. 2018;17(1):55.
Fukuda, T., Bouchi, R., Takeuchi, T., Tsujimoto, K., Minami, I., Yoshimoto, T., & Ogawa, Y. (2018). Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study. Cardiovascular Diabetology, 17(1), 55. https://doi.org/10.1186/s12933-018-0700-5
Fukuda T, et al. Sarcopenic Obesity Assessed Using Dual Energy X-ray Absorptiometry (DXA) Can Predict Cardiovascular Disease in Patients With Type 2 Diabetes: a Retrospective Observational Study. Cardiovasc Diabetol. 2018 04 10;17(1):55. PubMed PMID: 29636045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study. AU - Fukuda,Tatsuya, AU - Bouchi,Ryotaro, AU - Takeuchi,Takato, AU - Tsujimoto,Kazutaka, AU - Minami,Isao, AU - Yoshimoto,Takanobu, AU - Ogawa,Yoshihiro, Y1 - 2018/04/10/ PY - 2018/03/02/received PY - 2018/04/04/accepted PY - 2018/4/12/entrez PY - 2018/4/11/pubmed PY - 2019/1/29/medline KW - Cardiovascular disease KW - Dual-energy X-ray absorptiometry KW - Sarcopenic obesity KW - Type 2 diabetes KW - Visceral adiposity SP - 55 EP - 55 JF - Cardiovascular diabetology JO - Cardiovasc Diabetol VL - 17 IS - 1 N2 - BACKGROUND: Sarcopenic obesity, defined as reduced skeletal muscle mass and power with increased adiposity, was reported to be associated with cardiovascular disease risks in previous cross-sectional studies. Whole body dual-energy X-ray absorptiometry (DXA) can simultaneously evaluate both fat and muscle mass, therefore, whole body DXA may be suitable for the diagnosis of sarcopenic obesity. However, little is known regarding whether sarcopenic obesity determined using whole body DXA could predict incident cardiovascular disease (CVD). The aim of this study was to investigate the impact of sarcopenic obesity on incident CVD in patients with type 2 diabetes. METHODS: A total of 716 Japanese patients (mean age 65 ± 13 years; 47.0% female) were enrolled. Android fat mass (kg), gynoid fat mass (kg), and skeletal muscle index (SMI) calculated as appendicular non-fat mass (kg) divided by height squared (m2), were measured using whole body DXA. Sarcopenic obesity was defined as the coexistence of low SMI and obesity determined by four patterns of obesity as follows: android to gynoid ratio (A/G ratio), android fat mass or percentage of body fat (%BF) was higher than the sex-specific median, or body mass index (BMI) was equal to or greater than 25 kg/m2. The study endpoint was the first occurrence or recurrence of CVD. RESULTS: Over a median follow up of 2.6 years (IQR 2.1-3.2 years), 53 patients reached the endpoint. Sarcopenic obesity was significantly associated with incident CVD even after adjustment for the confounding variables, when using A/G ratio [hazard ratio (HR) 2.63, 95% CI 1.10-6.28, p = 0.030] and android fat mass (HR 2.57, 95% CI 1.01-6.54, p = 0.048) to define obesity, but not %BF (HR 1.67, 95% CI 0.69-4.02, p = 0.252), and BMI (HR 1.55, 95% CI 0.44-5.49, p = 0.496). CONCLUSIONS: The present data suggest that the whole body DXA is valuable in the diagnosis of sarcopenic obesity (high A/G ratio or android fat mass with low SMI) to determine the risk of CVD events in patients with type 2 diabetes. Meanwhile, sarcopenic obesity classified with low SMI, and high %BF or BMI was not associated with incident CVD. SN - 1475-2840 UR - https://www.unboundmedicine.com/medline/citation/29636045/Sarcopenic_obesity_assessed_using_dual_energy_X_ray_absorptiometry__DXA__can_predict_cardiovascular_disease_in_patients_with_type_2_diabetes:_a_retrospective_observational_study_ L2 - https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0700-5 DB - PRIME DP - Unbound Medicine ER -