Prospective evaluation of visceral fat in patients with type 2 diabetes by densitometry using a new CoreScan application

Abstract

Introduction. Visceral fat (VF) infiltrating the liver, pancreas and other structures within abdomen isindependent risk factor for type 2 diabetes (T2DM) and other metabolic abnormalities. Until recently, VF could be measured only by computed tomography and magnetic resonance. A new application CoreScan can measure the mass and volume of VF using total body densitometry (DXA). Aim of the study was to assess the changes in VF measured by DXA during a 12-month follow-up of patients with newly diagnosed T2DM who received standard treatments based on the current guidelines.

Material and methods. The study was performed on 50 postmenopausal women aged 64.68 ± 8 years with diabetes diagnosed by 75 g oral glucose tolerance test. Standard treatment was based on education, self-control, diet, and metformin. At the baseline and after 12 months of treatment, body fat (BF), hip fat, VF, lean tissue mass (Lean), fasting glucose, and glycated hemoglobin (HbA_1c) were assessed.

Results. Among studied women, 24 (48%) required treatments with only diet and lifestyle modification; in remaining, additionally metformin was given. None of the subjects required insulin therapy. Baseline mean HbA_1c was 6.92 ± 1.8% (52 mmol/mol). After 12 months there were decreases in fasting glucose (15.9%; p=0.0001), HbA1c (11.5%; p=0.013), weight(3.4%; p = 0.001), body mass index (3.4%; p = 0.0005), waist circumference (2%; p = 0.024) and BF (2.7%;p = 0.041), while Lean and VF did not change significantly. In the multiple regression analysis, weight reduction after 12 months was associated with BF decrease (b = 0.898; p = 0.001), but not with changes in Lean and VF.

Conclusions. In postmenopausal women with newly diagnosed T2DM, standard treatment based on lifestyle modyfications and metformin, results after 12 months in weight reduction associated with BF decrease but has no impact on lean tissue mass and visceral fatassessed by densitometry using a new CoreScan application.