Is visceral abdominal fat area a better indicator for hyperglycemic risk? Results from the Pinggu Metabolic Disease Study

Abstract

Aims/introduction: The aim of the present study was to analyze the strength of association between fasting plasma glucose (FPG), 2-h postprandial glucose (2h PPG), hemoglobin A1c (HbA1c), disposition index (DI) and nine anthropometrics measures, to explore the best indicator for hyperglycemia.

Materials and methods: Analyses were based on the cross-sectional data of 3,572 adults from the Pinggu Metabolic Disease Study. Anthropometrics were measured, visceral fat area (VFA) and subcutaneous fat area were calculated using an abdominal computed tomography scan. Linear regression was used to analyze the association between FPG, 2h PPG, HbA1c, DI and nine anthropometrics measures (height, weight, waist circumference [WC], body mass index and waist-to-hip ratio [WHR], waist-to-height ratio, VFA, subcutaneous fat area, and visceral-to-subcutaneous ratio). Logistic regression was further carried out to understand the association between per standard increase and risk for hyperglycemia.

Results: Higher VFA and subcutaneous fat area were associated with higher FPG, 2h PPG, HbA1c and DI after adjusting for other covariates. The strongest association observed after adjustment was WC for FPG, with one standard deviation greater WC being associated with 1.70 increased odds; WHR for 2h PPG, with one standard deviation greater WHR being associated with 1.83 increased odds. The strength of the association between VFA and FPG, 2h PPG, HbA1c, and DI was less than WHR and WC, but slightly stronger than body mass index. Stratified analyses showed that VFA performs better as an anthropometrics indicator in predicting hyperglycemic risk in women than men.

Conclusions: WHR and WC remain the best indicators for hyperglycemic risk among ahealthy Chinese population.

Keywords: Body mass index; Diabetes; Visceral fat.

Figure 1

Sex‐specific adjusted means (95% confidence interval) for (a) fasting plasma glucose (FPG), (b) 2‐h postprandial glucose (2h PPG), (c) hemoglobin A1c (HbA1c) and (d) disposition index (DI) by different anthropometrics and body composition measures. FPG and 2h PPG are values in mmol/L, HbA1c is value in percentage. Means were adjusted for age, household income level, smoking status, alcohol consumption, diabetes family history and physical activity.

Figure 2

Odds ratio and 95% confidence interval of hyperglycemic risk associated with per one standard deviation of each anthropometric and body composition measure. (a) fasting plasma glucose (FPG), 2‐h postprandial glucose (2h PPG), (c) hemoglobin A1c (HbA1c) and (d) disposition index (DI). Hyperglycemic risk was defined as FPG ≥5.6 mmol/L, 2h PPG ≥7.8 mmol/L, HbA1c ≥5.7% and DI below the sex‐specific 25th percentiles. Odds ratios were adjusted for age, sex, household income level, smoking status, alcohol consumption, diabetes family history and physical activity.