Rationale and Objectives
To investigate differences in sex-specific computed tomography abdominal fat and skeletal
muscle (SM) characteristics between type 2 diabetic retinopathy (DR) patients with
and without diabetic kidney disease (DKD).
Materials and Methods
This retrospective study included type 2 diabetes mellitus DR patients with/without
DKD between January 2019 and July 2021. Visceral adipose tissue (VAT), subcutaneous
adipose tissue, perirenal adipose tissue (PAT), intramuscular adipose tissue, and
SM areas were measured. Univariate and multivariate logistic regression analyses were
used to analyze risk factors for DKD. Correlation and multiple linear regression analyses
were used to clarify the association between computed tomography abdominal fat, SM
characteristics, and cystatin C.
Results
Two hundred and forty-one patients were enrolled and divided into DR with DKD group
(n = 142) and DR without DKD group (n = 99). In men, hypertension (OR: 5.21; 95%CI: 1.93–14.05; p = 0.001), diastolic pressure (OR: 1.07; 95%CI: 1.01–1.12; p = 0.011), hemoglobin (OR: 0.94; 95%CI: 0.92–0.97; p < 0.001) and PAT attenuation value (OR: 1.09; 95%CI: 1.01–1.17; p = 0.026) were independent risk factors for DKD progression in DR patients, while
the VAT index (VATI) (OR: 1.03; 95%CI: 1.01–1.05; p = 0.014) was an independent risk factor for female patients. Multiple linear regression
analysis revealed significant correlations between hypertension (β = 0.22, p = 0.002) and hemoglobin (β = -0.53, p < 0.001) with cystatin C in men, and a significant correlation between VATI and cystatin
C (β = 0.35, p = 0.037) in women after adjustment for confounders.
Conclusion
Female DR patients with elevated VAT level may suffer from a higher risk of DKD than
that in male patients.
KEY WORDS
Abbreviations:
T2DM (type 2 diabetes mellitus), DR (diabetic retinopathy), DKD (diabetic kidney disease), eGFR (estimated glomerular filtration rate), GHBA1c (glycosylated hemoglobin), CT (computed tomography), VAT (visceral adipose tissue), VATI (visceral adipose tissue index), SAT (subcutaneous adipose tissue), SATI (subcutaneous adipose tissue index), PAT (perirenal adipose tissue), PATI (perirenal adipose tissue index), IMAT (intramuscular adipose tissue), IMATI (intramuscular adipose tissue index), SM (skeletal muscle), SMI (skeletal muscle index), UACR (urine albumin-to-creatinine ratio), Scr (serum creatinine), ICCs (intra-class correlation coefficients), CIs (confidence intervals), OR (odds ratios), TAT (thrombin-antithrombin III complex), COVID-19 (Coronavirus disease 2019)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 22, 2023
Accepted:
January 25,
2023
Received in revised form:
January 25,
2023
Received:
December 7,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of The Association of University Radiologists.
