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Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study

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...

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Autores principales: Fukuda, Tatsuya, Bouchi, Ryotaro, Takeuchi, Takato, Tsujimoto, Kazutaka, Minami, Isao, Yoshimoto, Takanobu, Ogawa, Yoshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891961/
https://www.ncbi.nlm.nih.gov/pubmed/29636045
http://dx.doi.org/10.1186/s12933-018-0700-5
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author Fukuda, Tatsuya
Bouchi, Ryotaro
Takeuchi, Takato
Tsujimoto, Kazutaka
Minami, Isao
Yoshimoto, Takanobu
Ogawa, Yoshihiro
author_facet Fukuda, Tatsuya
Bouchi, Ryotaro
Takeuchi, Takato
Tsujimoto, Kazutaka
Minami, Isao
Yoshimoto, Takanobu
Ogawa, Yoshihiro
author_sort Fukuda, Tatsuya
collection PubMed
description 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 (m(2)), 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/m(2). 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-018-0700-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-58919612018-04-11 Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study Fukuda, Tatsuya Bouchi, Ryotaro Takeuchi, Takato Tsujimoto, Kazutaka Minami, Isao Yoshimoto, Takanobu Ogawa, Yoshihiro Cardiovasc Diabetol Original Investigation 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 (m(2)), 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/m(2). 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12933-018-0700-5) contains supplementary material, which is available to authorized users. BioMed Central 2018-04-10 /pmc/articles/PMC5891961/ /pubmed/29636045 http://dx.doi.org/10.1186/s12933-018-0700-5 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Investigation
Fukuda, Tatsuya
Bouchi, Ryotaro
Takeuchi, Takato
Tsujimoto, Kazutaka
Minami, Isao
Yoshimoto, Takanobu
Ogawa, Yoshihiro
Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title_full Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title_fullStr Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title_full_unstemmed Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title_short Sarcopenic obesity assessed using dual energy X-ray absorptiometry (DXA) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
title_sort sarcopenic obesity assessed using dual energy x-ray absorptiometry (dxa) can predict cardiovascular disease in patients with type 2 diabetes: a retrospective observational study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891961/
https://www.ncbi.nlm.nih.gov/pubmed/29636045
http://dx.doi.org/10.1186/s12933-018-0700-5
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