| Objective: Relationship of insulin resistance and abdominal obesity is closed. The studies shows that the ability of reaction to insulin in obesities decline half of those normal. So it starts resisting to the insulin. Abdominal obesity plays an important role in insulin resistance,which is associated with visceral fat and has a close relationship with vessel danger factor. Spiral CT was used to measure the area of intraabdominal adipose (I) and subcutaneous adipose(S), which are applied to calculate I/S ratio. The body fat index of obesity was measured and HOMA1-IRI was used to evaluated insulin resistance. Linear multiple variable regression was used to analyze the relationship between body fat index and HOMA1-IRI. 40 type 2 diabeties was chosen, and devide them into two groupes according to mid-range area of abdominal obesity. Indices of left ventricular diastolic function were determined by echocardiography and discussed the influence on left vent- ricular diastolic function of type 2 diabetics with different extent obesity.Methods: 10 cases with normal glucose tolerance which characterized in abdominal obesity (group A), 5 male and 5 female, the average age of whom was 55.7±10. 40 cases with type 2 diabetes (group B), 29 male and 11 female were selected. The average age was 56.2±12.1. The diabetes diagnose is in accordance with standard of WHO in 1999. The difference between two groups has no statistic significance(P>0.05). The fat index of obesity was measured, which included waistline, hip circumference,waist- to- hip ratio (WHR) and body mass index (BMI). Spiral CT was used to scan the level of umbilical plane in breathholding state and was measured the area of intraabdominal and subcutaneous adipose. Professional software was applied to calculate I/S. Blood samples were collected to assay the FBG, fasting insulin (FINS), fasting C peptide, triacylglycerol (TG), high density lipoprotein-cholesterol (HDL-C) and lowdensity lipoprotein- cholesterol (LDL- C) . Linear multiple variable regression was used to analyze the relationship between body fat index and HOMA1-IRI. 40 type 2 diabeties was chosen, and devide them into two groupes according to mid-range area of abdominal obesity. By determine indices of left ventricular diastolic function in echocardiography, discuss the influence on left ventricular diastolic function of type 2 diabetics of different extent obesity. The following indices of diastolic left ventricular function were evaluated,such as maximum velocity of passive mitral filling (Peak E), maximum velocity of active mitral filling (Peak A), ratio of passive to active velocity ( E/ A), left atrial diameter (LAD).The data between two groups was statistic to search their difference We analyzed all the data in SPSS 13.0 software.The comparisons between groups were done using student,s t-test for independent samples. Take a linear multiple variable regression as correlation analysis. Statistically significance was P < 0.05.Results:1 The area of intraabdominal adipose, subcutaneous adipos and I/S ratio in group B was lager than group A, (P<0.01). The level of HOMA1- IRI,lnHOMA1-IRI,FBG,FINS,waistline and BMI in group B are all higher than group A (P<0.05). There is no significantly differences between group A and B in the level of TG, HDL-C(P>0.05).(Table1, Table2, Table3)2 In a linear multiple variable regression , The level of lnHOMA1-IRI was associated with the the area of intraabdominal, subcutaneous adipose and I/S ratio, FBG, fasting insulin (FINS), fasting C peptide, lowdensity lipoprotein-cholesterol (LDL-C), high density lipoprotein- cholesterol (HDL-C), triacylglycerol(TG) and TC( r=0.95, 0.537, 0.61, 0.336, 0.266, 0.863,0.566, 0.361, 0.513, -0.45, 0.473, 0.39 respectively) (all P < 0.05)。3 From this test ,we can see, Diastolic ventricular dysfunction was lower in type 2 diabetes patients with abdominal obesity. Left ventricular diastolic function were measured. For example, maximum velocity of passive mitral filling (Peak E), maximum velocity of active mit ral filling (Peak A), ratio of passive to active velocity (E/A), left at rial diameter (LAD) In group D are significantly differences than those in group C. (all P < 0.05) . But EF%, which represents for left ventricular contract function have no differences between two groups.Conclusions1 Compared with people which characterized in abdominal obesity and normal glucose tolerance, those abdominal obesity type 2 diabetes mellitus have more intraabdominal adipose and subcutaneous adipose. It shows that intraabdominal adipose is an important factor in developing type 2 diabetes mellitus.2 Compared with other body fat index, the area of intraabdominal is the most correlated index in measuring extent of Insulin resistance. The area of intraabdominal and subcutaneous adipose scaned by spiral CT are effective methods to estimate obesity.3 Through comparing different left ventricular diastolic function of type 2 diabetics with different obesity extent, we find that the more obese,the worse left ventricular diastolic function they have. However, there is no significant difference of EF% between two groups It shows that the obesity has relationship with decline of left ventricular diastolic function,which comes up earlier than decline of left ventricular constract function.
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