Normal weight diabetic patients versus obese diabetics: Relation of overall and abdominal adiposity to vascular health

Objective: The present study investigated the impact of overall obesity defined by BMI and abdominal obesitydefined by WC on vascular atherosclerotic changes in obese and normal weight diabetic subjects. Design and methods: 285 subjects were divided according to presence diabetes mellitus (DM) and obesity: Group1 included 144 nonobese subjects without DM; Group 2 consisted of 141 type 2 diabetic patients. Then diabeticpatients were divided into two groups according to presence of overall obesity, defined by BMI and furthermore,abdominal obesity, defined by waist circumference (WC). Pulse wave velocity (PWV) and augmentation index (AI)were performed using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia).Results: Between Group Comparisons by BMI: Diabetic subjects with and without overall obesity did not differ fromone another in terms of AI and PWV.Between Group Comparisons by WC: AI as well as PWV increased consistently from Group 1 to Group 3, AI and PWV were significantly higher in abdominally obese diabetic subjects than in the diabetics without abdominal obesity (p= 0.008 and p = 0.013, respectively). Significant by-group differences in PWV and AI persisted after adjustment forage, sex, blood pressure, fasting glucose and BMI. Conclusions: Abdominal obesity defined by WC was associated with significantly higher AI and PWV in in bothdiabetic men and women; whereas overall obesity defined by BMI did not predict adverse vascular changes in thisstudy population. Abdominal obesity was associated with an adverse effect on blood vessels, independently of age,sex, blood pressure, fasting glucose and BMI.