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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1465577
This article is part of the Research Topic Cardiovascular Diseases Related to Diabetes and Obesity - Volume V View all 18 articles
The Association of Perirenal Adipose Tissue Accumulation with Left Ventricular Hypertrophy and the Mediating Role of Insulin Resistance: A Cross-sectional Study Involving 1112 Individuals with Type 2 Diabetes Mellitus
Provisionally accepted- Department of Endocrinology, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, China
Objective: Recent studies have underscored the metabolic and cardiovascular regulatory capacity of perirenal adipose tissue (PAT), implicating its potential involvement in the pathogenesis of left ventricular hypertrophy (LVH). This investigation aims to assess the relationship between increased PAT mass and LVH, while also examining the potential mediating role of insulin resistance in this relationship among individuals with type 2 diabetes mellitus (T2DM).Method: 1112 individuals with T2DM were prospectively recruited for this study.Perirenal fat thickness (PrFT), measured using unenhanced abdominal CT, served as a measure of PAT mass. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-c) was computed to assess insulin resistance. LVH was identified as left ventricular mass index (LVMI) >115 g/m² in men or LVMI >95 g/m² in women. The correlations of LVH risk with PrFT and TG/HDL-c were analyzed by weighted binomial logistic regression and restricted cubic splines (RCS) analyses. Furthermore, the mediating role of TG/HDL-c in this relationship was explored using the adjusted mediation analysis.Results: Participants in the LVH group displayed significantly higher PrFT and TG/HDL-c than the non-LVH group (P < 0.001). Adjusting for confounding factors, the LVMI demonstrated a positive correlation with PrFT (β=0.262, P<0.001) and TG/HDL-c (β=0.206, P<0.001). PrFT and TG/HDL-c emerged as independent variables for LVH, with odds ratios of 1.33 (95%CI:1.24-1.43, P<0.001) and 1.20 (95%CI:1.05-1.36, P=0.006), respectively. Each standard deviation increase in PrFT and TG/HDL-c conferred an additional 240% (P<0.001) and 41% (P=0.006) risk for LVH. A linear correlation of LVH risk with PrFT and TG/HDL-c was observed from RCS analysis (P for nonlinear and overall< 0.001). Moreover, TG/HDL-c mediated 13.4% of the association between PrFT and LVMI, and 8.5% between PrFT and LVH.Increased PAT accumulation contributes to an independent variable for LVH, with insulin resistance acting as a mediating variable in this relationship.
Keywords: Perirenal adipose tissue, left ventricular hypertrophy, Insulin Resistance, Perirenal fat thickness, Triglyceride to high-density lipoprotein cholesterol ratio
Received: 16 Jul 2024; Accepted: 20 Dec 2024.
Copyright: © 2024 Wang, Chen, Qiu and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiu Li Guo, Department of Endocrinology, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, China
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