Visceral fat alters baPWV in T2DM, promotes left ventricular remodeling

In patients with type 2 diabetes mellitus (T2DM), the impact of visceral fat (VF) on left ventricular remodeling (LVRM) can be attributed to changes in brachial-ankle pulse wave velocity (baPWV), a new study reports.

Researchers conducted a cross-sectional analysis of 905 patients (median age 55 years, 32.25 percent women) in whom VF area and subcutaneous fat area were measured using dual bioelectrical impedance analysis. BaPWV was evaluated using a volume-plethysmographic apparatus, while LV structure and diastolic function were assessed through echocardiography.

Multivariate linear regression analysis revealed a significant and inverse correlation between relative wall thickness and E/A in obese patients (β, –0.203; p=0.004). LV mass/height, meanwhile, was positively associated with E/E’ in both normal weight (β, 0.232; p=0.002) and obese (β, 0.232; p=0.008) participants.

Multivariate logistic regression analysis also found that baPWV was a significant and independent correlate of LVRM across body mass index categories. In particular, baPWV positively predicted LVRM in normal weight (odds ratio [OR], 1.001, 95 percent confidence interval [CI], 1.000–1.002; p=0.006), overweight (OR, 1.001, 95 percent CI, 1.000–1.002; p=0.008), and obese (OR, 1.003, 95 percent CI, 1.001–1.004; p=0.001) patients.

In addition, VF area was significantly associated with arterial stiffness in normal weight (OR, 1.032, 95 percent CI, 1.017–1.047; p<0.001) and overweight (OR, 1.011, 95 percent CI, 1.002–1.021; p=0.015) patients.

“VFA may influence LVRM through changes in baPWV, then influencing diastolic function,” the researchers said. “To the best of our knowledge, this is the first study that demonstrated the impact of VF on LVRM and diastolic function in view of baPWV.”