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Abstract：
The present study aimed to explore the association between serum cystatin C (Cys-C) levels and visceral fat area (VFA) in patients with type 2 diabetes mellitus (T2DM). A total of 208 previously diagnosed T2DM patients who visited our hospital from September 2019 to December 2021 were included and divided into three groups based on tertiles of Cys-C levels, namely, Groups C1, C2, and C3. The clinical data of the subjects were collected, biochemical parameters such as Cys-C levels were determined, and bioelectrical impedance analysis was applied to determine the VFA and subcutaneous fat area (SFA). The VFA in Group C1 was lower than that in Groups C2 and C3 (all P < 0.05), with no significant difference in VFA between Groups C2 and C3 (P > 0.05). Spearman\'s correlation analysis revealed that the serum Cys-C level was positively correlated with age, VFA, SFA, insulin resistance index, waist circumference, body mass index, systolic blood pressure, serum creatinine level, and blood uric acid level (r = 0.543, 0.353, 0.168, 0.148, 0.365, 0.264, 0.25, 0.497, and 0.155, respectively; P < 0.05) and negatively correlated with glycated haemoglobin levels (r = -0.175, P < 0.05). Univariate linear regression analysis revealed that VFA was positively correlated with the Cys-C level (β = 0.002, 95% CI = 0.001-0.003, P < 0.05), with an increase of 0.002 mg/L in the Cys-C level for each 1 cm2 increase in VFA. Further multivariate linear regression analysis was performed with the serum Cys-C level as the dependent variable and age, VFA, SFA, insulin resistance (HOMA-IR), WC, BMI, SBP, Cr, UA, and HbA1c as the independent variables. The results suggested that VFA was positively correlated with serum Cys-C level (β = 0.001, 95% CI = 0.000-0.002, P < 0.05), with serum Cys-C levels increasing by 0.001 mg/L for every 1 cm2 increase in VFA. Using a VFA ≥ 100 cm2 as the criterion for visceral obesity, ROC analysis revealed that the Cys-C level was a better predictor of visceral obesity, with an area under the ROC curve (AUC) of 0.701 (95% CI = 0.631-0.771, P < 0.05), an optimal cut-off of 0.905 mg/L, and a sensitivity and specificity of 58.3% and 75.2%, respectively. The results suggested that the serum Cys-C level was correlated with the VFA in patients with T2DM and that Cys-C may play a vital role in T2DM patients with visceral obesity.
摘要：
本研究旨在探讨2型糖尿病(T2DM)患者血清胱抑素C(Cys-C)水平与内脏脂肪面积(VFA)的相关性。从2019年9月至2021年12月在我院就诊的208例先前诊断的T2DM患者被纳入，并根据Cys-C水平的三元组分为三组。即,组C1、C2和C3。收集受试者的临床资料,生化参数，如Cys-C水平测定，并应用生物电阻抗分析来确定VFA和皮下脂肪面积（SFA）。C1组VFA低于C2组和C3组(均P<0.05),C2组和C3组VFA差异无统计学意义(P>0.05)。Spearman相关分析显示血清Cys-C水平与年龄呈正相关,VFA,SFA,胰岛素抵抗指数,腰围,身体质量指数,收缩压,血清肌酐水平，血尿酸水平(r=0.543、0.353、0.168、0.148、0.365、0.264、0.25、0.497、0.155;P<0.05)与糖化血红蛋白水平呈负相关(r=-0.175,P<0.05)。单因素线性回归分析显示VFA与Cys-C水平呈正相关(β=0.002,95%CI=0.001-0.003,P<0.05)。VFA每增加1cm2，Cys-C水平增加0.002mg/L。以血清Cys-C水平为因变量,以年龄,VFA,SFA,胰岛素抵抗（HOMA-IR），WC,BMI,SBP,Cr,UA,以HbA1c为自变量。结果提示VFA与血清Cys-C水平呈正相关(β=0.001,95%CI=0.000～0.002,P<0.05)。VFA每增加1cm2，血清Cys-C水平增加0.001mg/L。使用VFA≥100cm2作为内脏肥胖的标准，ROC分析显示Cys-C水平是内脏肥胖的较好预测指标,ROC曲线下面积（AUC）为0.701（95％CI=0.631-0.771，P<0.05），最佳临界值为0.905mg/L，敏感性和特异性分别为58.3%和75.2%，分别。提示2型糖尿病患者血清Cys-C水平与VFA相关,Cys-C在2型糖尿病合并内脏型肥胖患者中可能起重要作用。
