A Study of Body Composition in North Indian Type-2 DM Patients by DEXA and It's Relation with Insulin Resistance

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 842-862-Insulin Signaling & Action
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-859
Sandeep Kumar Mathur1, Poonam Punjabi2, Nitish Mathur*3, Deepak Kumar Gupta4, Prashant Mathur2, Jyoti Thanvi5 and Rati Mathur6
1SMS Medical College, Jaipur, India, 2SMS Medical College, Jaipur, Rajasthan, India, 3S M S Medical College, Rajasthan, India, 4University of Rajasthan, Jaipur, India, 5Jaipur College of Engineering & Research, Jaipur, India, 6S.M.S. Medical College, Jaipur, India
Aim: To study body composition of T2DM patients by DEXA and find relation between regional DEXA parameters and insulin resistance measured as HOMA-R.

Subjects and Methods: Fifty eight Type-2 DM patients (48.78 ± 8.649 yrs M: F ratio 38:20) and 72 age matched controls (41.67 ± 9.197 yrs M: F ratio 36:36) participated in the study. The clinical & biochemical parameters studied were, blood glucose, lipid profile (Total cholesterol, Triglycerides (TG), LDL, HDL, and VLDL), Insulin, HOMA–R, HOMA-B. Body composition was estimated by dual energy X-ray absorptiometry (DEXA) using Hologic Explorer model (S/N91395). The parameters studied were bone mineral content (BMC), lean mass (gm), Fat (gm), total mass (gm) and % fat, in all limbs, trunk, head  area and total body. Student paired t test and Mann Whitney tests were used for comparison of study parameters between diabetics and controls. Multiple linear regression test was done for comparison of age and sex adjusted study parameters between both the groups. This test was also done for finding relationship between DEXA parameters and HOMA-R.

Results:  Diabetics had BMI comparable to controls. They had a higher waist circumference. They also had higher HOMA-R, TG levels and lower HOMA-β and HDL levels compared to controls. In diabetics lean mass was significantly higher in trunk (β=.187, p=.019). There was no statistically significant difference in other DEXA parameters between both the groups.

Among the controls there was significant positive association between HOMA-R and total body fat content (β=.351, p=.001) and limb fat mass (β=.336, p=.011). Also there was significant positive association between limb lean mass (β=.635, p=.002) and head lean mass (β=.551,p=.000). There was significant negative association between limb (β=.551, p=.000), head BMC (β=-.384, p=.0023) and HOMA –R.

Among diabetics there was no association between total body and regional fat content. There was significant positive association between trunk lean mass and HOMA –R (β=.567, p=.038).Also there was weak association between limb lean mass (β=.319, p=.062).and HOMA-R. There was significant negative association between head BMC and HOMA –R (β=-.585, p=.029) in diabetics.

Conclusion: Diabetics despite high insulin resistance had comparable overall adipose tissue mass and peculiar body composition comprising of higher trunk lean mass. Association of HOMA-R with lean mass instead of adipose tissue mass (as seen in controls) in diabetics needs further investigations.

Nothing to Disclose: SKM, PP, NM, DKG, PM, JT, RM

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