Clinical research

Relationship between abdominal fat area and first-phase insulin secretion function of pancreatic β-cells in patients with type 2 diabetes

  • LU Jiaping ,
  • LIU Xing ,
  • ZHANG Linshan ,
  • ZHAO Lin ,
  • ZHANG Min ,
  • LI Xiaoying ,
  • LIU Yuejun
Expand
  • 1.Department of Endocrinology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China
    2.Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai 200032, China
LIU Yuejun, E-mail: liu.yuejun@zs-hospital.sh.cn.

Received date: 2024-07-09

  Accepted date: 2024-10-15

  Online published: 2025-01-28

Supported by

National Natural Science Foundation of China(81900771);Excellent Youth Program of Zhongshan Hospital(2019ZSYQ19);Program of Shanghai Qingpu District Health Commission(QWJ2022-01)

Abstract

Objective ·To explore the relationship between abdominal fat area and the first-phase insulin secretion function of pancreatic β-cells in patients with type 2 diabetes, and to establish predictive models of nomogram. Methods ·From October 2020 to February 2024, a total of 120 patients with type 2 diabetes, who were hospitalized in the Department of Endocrinology, Zhongshan Hospital, Fudan University, and underwent the arginine stimulation test, were recruited for the study. Patients were categorized into an insulin secretion function-preserved group (i.e. preserved group) and a depleted group according to the results of the arginine stimulation test. General information and laboratory parameters were collected. Subcutaneous fat area (SFA) and visceral fat area (VFA) were non-invasively measured by abdominal fat detector. The variables were screened by univariate analysis, and multivariate Logistic regression was used to identify the influencing factors, followed by the establishment of predictive models of nomogram. The area under the receiver operating characteristic curve (ROC curve) and concordance index (C-index) were used to evaluate the predictive performance of the models. Results ·Seventy-four patients (61.7%) were assigned to the preserved group, and 46 patients (38.3%) to the depleted group. Patients in the depleted group had a longer diabetes duration, lower waist circumference, hip circumference, body mass index (BMI), uric acid, free triiodothyronine (FT3), adipose tissue insulin resistance (Adipo-IR), ankle brachial index (ABI), SFA and VFA, and higher brachial ankle pulse wave velocity (baPWV). Multivariate Logistic regression showed that SFA, VFA, FT3, baPWV, and ABI were independent risk factors for the depleted insulin secretion function. Nomogram models were constructed based on the above risk factors. Among them, the model comprising VFA, FT3, ABI, and baPWV showed the best predictive performance with a C-index of 0.81. Conclusion ·SFA and VFA are lower in patients with depleted first-phase insulin secretion function of pancreatic β-cells. The nomogram model, including SFA or VFA, can be used to predict first-phase insulin secretion function of pancreatic β-cells in patients with type 2 diabetes.

Cite this article

LU Jiaping , LIU Xing , ZHANG Linshan , ZHAO Lin , ZHANG Min , LI Xiaoying , LIU Yuejun . Relationship between abdominal fat area and first-phase insulin secretion function of pancreatic β-cells in patients with type 2 diabetes[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(1) : 42 -50 . DOI: 10.3969/j.issn.1674-8115.2025.01.005

References

1 SUN H, SAEEDI P, KARURANGA S, et al. IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045[J]. Diabetes Res Clin Pract, 2022, 183: 109119.
2 NAUCK M A, WEFERS J, MEIER J J. Treatment of type 2 diabetes: challenges, hopes, and anticipated successes[J]. Lancet Diabetes Endocrinol, 2021, 9(8): 525-544.
3 HANNON T S, KAHN S E, UTZSCHNEIDER K M, et al. Review of methods for measuring β-cell function: design considerations from the Restoring Insulin Secretion (RISE) Consortium[J]. Diabetes Obes Metab, 2018, 20(1): 14-24.
4 C?TOI A F, BUSETTO L. Metabolically healthy obesity and bariatric surgery[J]. Obes Surg, 2019, 29(9): 2989-3000.
5 KIM E H, KIM H K, LEE M J, et al. Sex differences of visceral fat area and visceral-to-subcutaneous fat ratio for the risk of incident type 2 diabetes mellitus[J]. Diabetes Metab J, 2022, 46(3): 486-498.
6 GYLLENHAMMER L E, ALDERETE T L, TOLEDO-CORRAL C M, et al. Saturation of subcutaneous adipose tissue expansion and accumulation of ectopic fat associated with metabolic dysfunction during late and post-pubertal growth[J]. Int J Obes (Lond), 2016, 40(4): 601-606.
7 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志, 2021, 13(4): 315-409.
  Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)[J]. Chinese Journal of Diabetes, 2021, 13(4): 315-409.
8 TER HORST K W, VAN GALEN K A, GILIJAMSE P W, et al. Methods for quantifying adipose tissue insulin resistance in overweight/obese humans[J]. Int J Obes (Lond), 2017, 41(8): 1288-1294.
9 朱小鹏, 颜红梅, 常薪霞, 等. 精氨酸刺激试验评估胰岛β细胞1相分泌功能的价值及对2型糖尿病治疗的指导作用[J]. 中国临床医学, 2017, 24(4): 548-553.
  ZHU X P, YAN H M, CHANG X X, et al. The value of arginine stimulation test in evaluating the first-phase insulin secretion and its guiding role for the treatment of type 2 diabetes mellitus[J]. Chinese Journal of Clinical Medicine, 2017, 24(4): 548-553.
10 SASSO M, BEAUGRAND M, DE LEDINGHEN V, et al. Controlled attenuation parameter (CAP): a novel VCTE? guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes[J]. Ultrasound Med Biol, 2010, 36(11): 1825-1835.
11 SMITH U, KAHN B B. Adipose tissue regulates insulin sensitivity: role of adipogenesis, de novo lipogenesis and novel lipids[J]. J Intern Med, 2016, 280(5): 465-475.
12 LI R, LU W, JIA J, et al. Relationships between indices of obesity and its cardiovascular comorbidities in a Chinese population[J]. Circ J, 2008, 72(6): 973-978.
13 NEELAND I J, TURER A T, AYERS C R, et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults[J]. JAMA, 2012, 308(11): 1150-1159.
14 LI H T, WU G Y, FANG Q C, et al. Fibroblast growth factor 21 increases insulin sensitivity through specific expansion of subcutaneous fat[J]. Nat Commun, 2018, 9(1): 272.
15 陈姝, 储爱卉, 卞文轩, 等. 2型糖尿病患者骨骼肌质量与胰岛功能相关性研究[J]. 中国临床研究, 2024, 37(7): 1045-1050.
  CHEN S, CHU A H, BIAN W X, et al. Correlation between skeletal muscle mass and islet function in patients with type 2 diabetes mellitus[J]. Chinese Journal of Clinical Research, 2024, 37(7): 1045-1050.
16 SYED I, RUBIN DE CELIS M F, MOHAN J F, et al. PAHSAs attenuate immune responses and promote β cell survival in autoimmune diabetic mice[J]. J Clin Invest, 2019, 129(9): 3717-3731.
17 SUN Y C, ZHU Y Q, ZHANG L, et al. Relationship between insulin secretion and arterial stiffness in essential hypertension[J]. Int J Hypertens, 2021, 2021: 5015797.
18 ZHENG M Y, ZHANG X Y, CHEN S H, et al. Arterial stiffness preceding diabetes: a longitudinal study[J]. Circ Res, 2020, 127(12): 1491-1498.
19 NIE F Z, HE J A, CAO H, et al. Predictive value of abnormal ankle-brachial index in patients with diabetes: a meta-analysis[J]. Diabetes Res Clin Pract, 2021, 174: 108723.
20 TEIXEIRA P F D S, DOS SANTOS P B, PAZOS-MOURA C C. The role of thyroid hormone in metabolism and metabolic syndrome[J]. Ther Adv Endocrinol Metab, 2020, 11: 2042018820917869.
21 MORAN C, MCENIERY C M, SCHOENMAKERS N, et al. Dyslipidemia, insulin resistance, ectopic lipid accumulation, and vascular function in resistance to thyroid hormone β[J]. J Clin Endocrinol Metab, 2021, 106(5): e2005-e2014.
22 YAN Y, NIU Z M, SUN C, et al. Hepatic thyroid hormone signalling modulates glucose homeostasis through the regulation of GLP-1 production via bile acid-mediated FXR antagonism[J]. Nat Commun, 2022, 13(1): 6408.
23 VERGA FALZACAPPA C, PETRUCCI E, PATRIARCA V, et al. Thyroid hormone receptor TRβ1 mediates Akt activation by T3 in pancreatic β cells[J]. J Mol Endocrinol, 2007, 38(1/2): 221-233.
24 VERGA FALZACAPPA C, PATRIARCA V, BUCCI B, et al. The TRβ1 is essential in mediating T3 action on Akt pathway in human pancreatic insulinoma cells[J]. J Cell Biochem, 2009, 106(5): 835-848.
Outlines

/