Relationship of abdominal fat with metabolic disorders in diabetes mellitus patients.

In this study, we examined the relationships of the fat distribution with the clinical parameters, microangiopathy, and coagulation disorders in Japanese diabetic patients, distinguishing between males and females. To investigate these relationships, the clinical parameters of the patients were compared with the total abdominal fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), BMI, and percent body fat. In addition, microangiopathies and coagulation disorders of the patients were also compared with the fat distribution. In the male patients, the insulin level, triglyceride (TG) level, and diastolic blood pressure significantly correlated with both VFA and SFA. The HDL cholesterol (HDL-Chol) level and systolic blood pressure also significantly correlated with VFA, but not with SFA. In the female patients, the insulin level, TG level, HDL-Chol level and systolic blood pressure significantly correlated with VFA. On the other hand, only the systolic and diastolic blood pressures significantly correlated with SFA. The fibrinogen and thrombin-antithrombin III complex (TAT) levels significantly correlated with VFA only in the female patients. The male patients with macroalbuminuria had significantly larger VFA than those with microalbuminuria or normoalbuminuria. However, SFA had no relation with the urinary albumin excretion rate. The multiple regression analysis showed that VFA was an independent variable associated with diabetic nephropathy in the male patients. In conclusion, VFA plays more important role than SFA in the metabolic disorders and diabetic nephropathy in the Japanese diabetic patients. In the female diabetic patients, VFA may be associated with disorders of coagulation and fibrinolysis.