Authors: Anan, F.; Masaki, T.¹; Eto, T.²; Iwao, T.²; Shimomura, T.²; Umeno, Y.²; Eshima, N.¹; Saikawa, T.¹; Yoshimatsu, H.¹

Source: European Journal of Clinical Investigation, Volume 39, Number 5, May 2009 , pp. 368-374(7)

Publisher: Wiley-Blackwell

Abstract:

Background 

The presence of white matter lesions (WML) is an important prognostic factor for the development of stroke. The elevated visceral fat accumulation (VFA) has been reported to be closely related to the development of atherosclerosis. This preliminary study was therefore designed to test the hypothesis that the presence of WML correlates with VFA and insulin resistance in type 2 diabetic patients not receiving insulin treatment. Material and methods 

Based on brain magnetic resonance imaging (MRI), 95 type 2 diabetic patients were divided into two groups: WML-positive group (aged 59 ± 7 years, mean ± SD n = 37) and WML-negative group (aged 58 ± 5, years, n = 58). The level of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin, homeostasis model assessment (HOMA) index, and haemoglobin A1c. The fat distribution was evaluated by measuring the visceral fat accumulation by abdominal computerized tomography at the umbilical level. Results 

The body mass index was higher in the WML-positive group than in the WML-negative group (P < 0·005). Plasma levels of triglycerides were higher while high-density lipoprotein cholesterol was lower in the WML-positive group than in the WML-negative group (P < 0·05 and P < 0·01, respectively). FPG (P < 0·01), insulin concentrations (P < 0·0001), HOMA index (P < 0·0001) and VFA (<0·0001) levels were higher in the WML-positive group than in the WML-negative group. Multivariate logistic analysis revealed that WML was independently predicted by the high VFA and insulin resistance (P < 0·001, P < 0·0001, respectively). Conclusions 

The results of this preliminary study indicate that the presence of WML was associated with the high VFA and insulin resistance in Japanese patients with type 2 diabetes mellitus. Further larger cohort studies are warranted to confirm these findings.

Keywords: Insulin resistance; type 2 diabetes mellitus; visceral fat accumulation; white matter lesion

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2362.2009.02103.x

Affiliations: 1: Oita University, Oita, Japan 2: Oita Red Cross Hospital, Oita, Japan

Publication date: 2009-05-01

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