A novel parameter, weight-adjusted waist index represents sarcopenic obesity in newly diagnosed type 2 diabetes mellitus

초록

Background As metabolic significance of sarcopenic obesity (SO) is revealed, exploring appropriate index to detect SO is important, especially for type 2 diabetes mellitus (T2DM) who have more serious metabolic dysfunction if they accompany SO. Aim We aimed to develop an appropriate anthropometric index to discriminate SO and predict SO-related metabolic risks in newly diagnosed T2DM patients. We also compared the usefulness of each index across different age groups. Method We used the data of 515 participants from the Korea Guro Diabetes Program (KGDP) cohort to compare the waist-hip ratio (WHR), waist-height ratio (WHtR), and weight-adjusted waist index (WWI) for predicting SO in newly diagnosed T2DM patients. SO is defined as a dual-energy X-ray absorptiometry-measured low muscle mass plus a low muscle strength and/or reduced physical performance as assessed by handgrip strength and gait speed. The WHR, WHtR, and WWI are calculated by dividing the waist circumference (WC) by the hip circumference, height, and √ weight, respectively. Results The WHR and WHtR were positively correlated with the amount of fat and muscle mass represented by trunk fat amount (TFA) and appendicular skeletal muscle mass (ASM), whereas the WWI showed an association in the opposite direction: a positive correlation with the TFA (r = 0.501, p < 0.001) and a negative correlation with the ASM (r = –0.272, p < 0.001). When the third tertile of WWI was compared with the first tertile, the odds ratio (OR) for SO was 5.72 (95% confidence interval: 2.06–15.88, p < 0.001), the most prominent ORs value among the three indices. Furthermore, the WWI exhibited a significant positive correlation with albuminuria, the mean brachial ankle pulse wave velocity, and low-density lipoprotein cholesterol and triglyceride levels in patients with an age ≥65. Conclusion WWI is the preferable anthropometric index for predicting SO in newly diagnosed T2DM participants. A correlation between WWI and cardiometabolic risk factors was evident in elderly patients.