To Investigate The Relationship Between Adipose Tissue Distribution And Cys-c Under Different Glucose Metabolism States

Objective:Previous studies have found that serum cystatin C levels in people with higher BMI are significantly higher than those in people with normal BMI.It is that overweight or obesity may have an important impact on serum cystatin C.Obesity includes abnormal total fat content and abnormal distribution of adipose tissue.But BMI only excludes the influence of height on body weight,which cannot effectively reflect the distribution of human adipose tissue.Therefore,the aim of our study is to investigate the influence of adipose tissue distribution on serum cystatin C.Methods:In this study,146 cases were included as the research subjects.All participants were assigned to normal glucose tolerance group(49people)and hyperglycemia group(97people)according to OGTT.The hyperglycemia group includes IGR and T2DM.85subjects diagnosed with T2DM in the hyperglycemia group were analyzed and compared according to the same method.The clinical date and serum Cys-c concentrations were collected from all participants.In the study,the VAT and the SAT were measured by visceral fat area measuring instrument.The Fat%of all subjects was measured by dual-energy X-ray absorption method and then the Fat mass index(FMI)was further calculated.Based on the HOMA homeostatic model,pancreatic isletβcell function,insulin resistance and insulin sensitivity were comprehensively assessed by HOMA-β,HOMA-IR and HOMR-IS.To discuss the correlation between distribution of adipose tissue and serum Cys-c under different glucose metabolism states.Results:1.Comparison of baseline data between the normal glucose tolerance group and the hyperglycemia group showed that there were significant differences in AGE,Sex,Height,Hb A1C,FPG,2h PPG,HOMA-β,Scr,e GFR,drinking and smoking(P<0.05),and the difference between Weight,BMI,VAT,SAT,VAT/SAT,Fat%,FMI,WC,HC,WHR,Cys-c were not statistically significant(P>0.05).2.In the normal glucose tolerance group:(1)The subjects in this group were assigned to BMI<24kg/m~2group and BMI≥24kg/m~2group according to BMI;All subjects were divided into Fat%<30%group and Fat%≥30%group according to Fat%;All subjects were divided into VAT<100cm~2group and VAT≥100cm~2group according to the VAT area.In the above groups,there was no significant difference in serum Cys-c(P>0.05).(2)Correlation analysis showed that serum Cys-c was positively correlated with VAT(P<0.05),and was not correlated with weight,BMI,Fat%,FMI,SAT,VAT/SAT,WC,HC,WHR(P>0.05).3.In the hyperglycemia group:(1)The subjects in this group were assigned to BMI<24kg/m~2group and BMI≥24kg/m~2group according to BMI;All subjects were divided into Fat%<30%group and Fat%≥30%group according to Fat%;All subjects were divided into VAT<100cm~2group and VAT≥100cm~2group according to the VAT area.The results showed that serum Cys-c in BMI≥24kg/m~2group was higher than that in BMI<24kg/m~2group(0.86(0.73,1.08)vs0.73(0.66,0.85),P<0.05).No significant difference was found in other grouping conditions(P>0.05).(2)The correlation analysis found that Cys-c had a positive correlation with BMI,WHR,Fat%(P<0.05),and had no correlation with VAT,SAT,FMI,VAT/SAT,WC,HC(P>0.05).(3)Multiple regression analysis showed that Fat%is one of the main influencing factors of serum Cys-c.4.In T2DM group:(1)The level of Cys-c in T2DM group was obviously higher than that in normal glucose tolerance group(0.79(0.67,0.98)vs0.74(0.60,0.90),P<0.05).(2)The research objects in this group were assigned to BMI<24kg/m~2group and BMI≥24kg/m~2group according to BMI;All subjects were divided into Fat%<30%group and Fat%≥30%group according to Fat%;All subjects were divided into VAT<100cm~2group and VAT≥100cm~2group according to the VAT area.The results showed that serum Cys-c in BMI<24kg/m~2group was lower than that in BMI≥24kg/m~2group(0.75(0.66,0.89)vs0.88(0.72,1.17),P<0.05).The difference of Cys-c concentrations in the remaining groups was not statistically significant(P>0.05).(3)The results of correlation analysis suggested that Cys-c was not related with the fat content or the fat distribution(P>0.05).5.In the normal glucose tolerance group:The VAT and SAT had a positive relevance with TG,Scr and UA(P<0.05),a negative relevance with HDL-C(P<0.05),and no correlation with LDL-C(P>0.05);There existed a positive relation between the VAT and TC(P<0.05),while the SAT had no correlation with TC(P>0.05).In the hyperglycemia group,the VAT was positively associated with TG,UA and Scr(P<0.05),negatively related to HDL-C(P<0.05),and not concerned with TC and LDL-C(P>0.05).The SAT was only positively associated with TG(P<0.05).6.In the normal glucose tolerance group:The VAT was positively associated with FPG,2h PPG,HOMA-IR(P<0.05).It was negatively related to HOMA-IS(P<0.05),and not correlated with HOMA-β(P>0.05).The SAT was positively correlated with2h PPG(P<0.05).It is not correlated with FPG,HOMA-IR,HOMA-IS,HOMA-β(P>0.05).In the hyperglycemia group:There was a positive correlation between the VAT and HOMA-IR(P<0.05).The VAT was negative relevance with HOMA-IS(P<0.05),and not associated with FPG,2h PPG,HOMA-β(P>0.05).The SAT had no correlation with FPG,2h PPG,HOMA-IR,HOMA-βand HOMA-IS(P>0.05).Conclusions:1.Compared with SAT in the normal glucose tolerance group,VAT may be the influencing factor of Cys-c.2.Compared with normal BMI in the hyperglycemia group,excessive BMI may be an influencing factor of Cys-c.3.Compared with the normal glucose tolerance group,it was found that Cys-c may have a certain clinical association with the development of T2DM.4.Compared with BMI and WHR in the hyperglycemia group,it was found that Fat%was more closely related to Cys-c.5.In all the study subjects,it was found that VAT and SAT can affect blood lipid metabolism,and VAT had a greater impact on blood lipids than SAT.6.In all study subjects,it was found that VAT was more related to insulin resistance compared to SAT.