ObjectiveTo analyze the correlation between visceral adiposity index (VAI), lipid accumulation index (LAP) and diabetic cardiac autonomic neuropathy (DCAN).
MethodsTwo hundred and fifty patients with type 2 diabetes mellitus were selected and divided into DCAN group and non-DCAN group according to whether DCAN occurred.The VAI, LAP, Ewing test parameters and related biochemical indexes were compared between the two groups.According to the quartile level of VAI and LAP, the two groups were subdivided into 4 groups (V1-V4 group, L1-L4 group), and the distribution of DCAN in each group was compared.Spearman correlation analysis was used to evaluate the correlation between VAI, LAP levels and each Ewing test parameter of DCAN patients, logistic regression analysis was used to calculate the risk of DCAN in patients with different VAI and LAP levels, and ROC curve analysis was used to evaluate the predictive diagnostic value of each body fat indicator on DCAN.
ResultsAmong the 250 patients with type 2 diabetes mellitus, 158 had DCAN and 92 did not have DCAN, and the incidence of DCAN was 63.20%.The age, duration of diabetes mellitus, waist circumference, body mass index, waist to body ratio, waist to hip ratio, VAI, LAP, total cholesterol, triacylglycerol, and low-density lipoprotein cholesterol levels of patients in the DCAN group were significantly higher than those in the non-DCAN group (P < 0.01), while the level of high-density lipoprotein cholesterol was significantly lower than that in the non-DCAN group (P < 0.01).With the increase of VAI and LAP quartiles, the proportion of DCAN patients increased continuously, and the difference of which was statistically significant (P < 0.01).Logistic regression analysis showed that after adjusting the risk factors, the risk of DCAN in the V4 group was about 7.439 times of that in the V1 group (P < 0.05), and the risk of DCAN in the L4 group was about 53.241 times of that in the L1 group (P < 0.01).Spearman correlation analysis showed that VAI and LAP were negatively correlated with Valsalva R-R ratio, heart rate difference of deep breathing, and heart rate difference in upright position (P < 0.05 to P < 0.01), and positively correlated with systolic pressure difference in upright position and diastolic pressure difference in upright position (P < 0.05 to P < 0.01).ROC curve analysis results showed that the area under the curve predicted by VAI and LAP for DCAN in male and female patients was higher than other indicators, and the area under the curve predicted by VAI and LAP in male patients was higher than that in female patients (P < 0.05).
ConclusionsThe risk of DCAN is positively correlated with VAI and LAP levels.With the increase of VAI and LAP levels, the risk of DCAN increases.Compared with other body fat indicators, VAI and LAP have better predictive ability for DCAN, and both have higher predictive value in male.
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