Skip to main content
Top
Published in: Diabetes Therapy 4/2015

Open Access 01-12-2015 | Brief Report

Comparison of Adipose Distribution Indices with Gold Standard Body Composition Assessments in the EMPA-REG H2H SU Trial: A Body Composition Sub-Study

Authors: Ian J. Neeland, Darren K. McGuire, Björn Eliasson, Martin Ridderstråle, Cordula Zeller, Hans J. Woerle, Uli C. Broedl, Odd Erik Johansen

Published in: Diabetes Therapy | Issue 4/2015

Login to get access

Abstract

Introduction

Excess adiposity contributes to cardiometabolic disease. Although adipose depots can be measured using imaging, implementation remains limited in practice. Data comparing surrogate indices of total and visceral adiposity with gold standard measurements in the context of a clinical trial population are lacking. We explored the relationships between adipose distribution indices and imaging assessments of body composition using baseline data from the EMPA-REG H2H SU™ trial.

Methods

118 participants from the Phase III trial of empagliflozin 25 mg vs. glimepiride 1–4 mg enrolled in a dedicated sub-study underwent assessment of total fat and fat-free mass by dual x-ray absorptiometry (n = 93) and abdominal visceral (VAT) and subcutaneous adipose tissue by magnetic resonance imaging (n = 99). Correlations with waist circumference (WC), estimated total body fat (eTBF), index of central obesity (ICO), and visceral adiposity index (VAI) were assessed.

Results

eTBF was highly representative of total body fat (Spearman’s ρ = 0.73, P < 0.001) but not associated with VAT. WC and ICO were strongly, and VAI to a lesser degree, correlated with VAT (ρ = 0.66, P < 0.001; ρ = 0.52, P < 0.001; ρ = 0.24, P = 0.02, respectively).

Conclusion

These findings support the use of eTBF and WC or ICO as surrogate indices for total body fat and VAT, respectively, in the absence of gold standard imaging methodology.
Appendix
Available only for authorised users
Literature
1.
go back to reference Vega GL, Adams-Huet B, Peshock R, Willett D, Shah B, Grundy SM. Influence of body fat content and distribution on variation in metabolic risk. J Clin Endocrinol Metab. 2006;91:4459–66.CrossRefPubMed Vega GL, Adams-Huet B, Peshock R, Willett D, Shah B, Grundy SM. Influence of body fat content and distribution on variation in metabolic risk. J Clin Endocrinol Metab. 2006;91:4459–66.CrossRefPubMed
2.
go back to reference Despres JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126:1301–13.CrossRefPubMed Despres JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126:1301–13.CrossRefPubMed
3.
go back to reference Neeland IJ, Ayers CR, Rohatgi AK, et al. Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults. Obesity (Silver Spring). 2013;21:E439–47.PubMedCentral Neeland IJ, Ayers CR, Rohatgi AK, et al. Associations of visceral and abdominal subcutaneous adipose tissue with markers of cardiac and metabolic risk in obese adults. Obesity (Silver Spring). 2013;21:E439–47.PubMedCentral
4.
go back to reference Neeland IJ, Gupta S, Ayers CR, et al. Relation of regional fat distribution to left ventricular structure and function. Circ Cardiovasc Imaging. 2013;6:800–7.CrossRefPubMedPubMedCentral Neeland IJ, Gupta S, Ayers CR, et al. Relation of regional fat distribution to left ventricular structure and function. Circ Cardiovasc Imaging. 2013;6:800–7.CrossRefPubMedPubMedCentral
5.
go back to reference Neeland IJ, Turer AT, Ayers CR, et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA. 2012;308:1150–9.CrossRefPubMedPubMedCentral Neeland IJ, Turer AT, Ayers CR, et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA. 2012;308:1150–9.CrossRefPubMedPubMedCentral
6.
7.
go back to reference Luo W, Guo Z, Wu M, Hao C, Zhou Z, Yao X. Index of central obesity as a parameter to replace waist circumference for the definition of metabolic syndrome in predicting cardiovascular disease. J Cardiovasc Med (Hagerstown). 2014;15:738–44.CrossRef Luo W, Guo Z, Wu M, Hao C, Zhou Z, Yao X. Index of central obesity as a parameter to replace waist circumference for the definition of metabolic syndrome in predicting cardiovascular disease. J Cardiovasc Med (Hagerstown). 2014;15:738–44.CrossRef
9.
go back to reference Parikh RM, Joshi SR, Pandia K. Index of central obesity is better than waist circumference in defining metabolic syndrome. Metab Syndr Relat Disord. 2009;7:525–7.CrossRefPubMed Parikh RM, Joshi SR, Pandia K. Index of central obesity is better than waist circumference in defining metabolic syndrome. Metab Syndr Relat Disord. 2009;7:525–7.CrossRefPubMed
10.
11.
go back to reference Ridderstrale M, Andersen KR, Zeller C, Kim G, Woerle HJ, Broedl UC. Comparison of empagliflozin and glimepiride as add-on to metformin in patients with type 2 diabetes: a 104-week randomised, active-controlled, double-blind, phase 3 trial. Lancet Diabetes Endocrinol. 2014;2:691–700.CrossRefPubMed Ridderstrale M, Andersen KR, Zeller C, Kim G, Woerle HJ, Broedl UC. Comparison of empagliflozin and glimepiride as add-on to metformin in patients with type 2 diabetes: a 104-week randomised, active-controlled, double-blind, phase 3 trial. Lancet Diabetes Endocrinol. 2014;2:691–700.CrossRefPubMed
12.
go back to reference Neeland IJ, McGuire DK, Chilton B, Crowe S, Lund SS, Woerle HJ, Broedl UC, Johansen OE. Empagliflozin reduces body weight and indices and adipose distribution in patients with type 2 diabetes mellitus. Diabetes Vasc Dis Res. 2015. (In Press). Neeland IJ, McGuire DK, Chilton B, Crowe S, Lund SS, Woerle HJ, Broedl UC, Johansen OE. Empagliflozin reduces body weight and indices and adipose distribution in patients with type 2 diabetes mellitus. Diabetes Vasc Dis Res. 2015. (In Press).
13.
go back to reference Wilmore JH, Behnke AR. An anthropometric estimation of body density and lean body weight in young men. J Appl Physiol. 1969;27:25–31.CrossRefPubMed Wilmore JH, Behnke AR. An anthropometric estimation of body density and lean body weight in young men. J Appl Physiol. 1969;27:25–31.CrossRefPubMed
14.
go back to reference Wilmore JH, Behnke AR. An anthropometric estimation of body density and lean body weight in young women. Am J Clin Nutr. 1970;23:267–74.CrossRefPubMed Wilmore JH, Behnke AR. An anthropometric estimation of body density and lean body weight in young women. Am J Clin Nutr. 1970;23:267–74.CrossRefPubMed
15.
go back to reference Amato MC, Giordano C, Galia M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33:920–2.CrossRefPubMedPubMedCentral Amato MC, Giordano C, Galia M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33:920–2.CrossRefPubMedPubMedCentral
16.
go back to reference Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24:69–71.PubMedPubMedCentral Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24:69–71.PubMedPubMedCentral
17.
go back to reference Pouliot MC, Despres JP, Lemieux S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460–8.CrossRefPubMed Pouliot MC, Despres JP, Lemieux S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol. 1994;73:460–8.CrossRefPubMed
18.
go back to reference Coutinho T, Goel K, Correa de Sa D, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553–60.CrossRefPubMed Coutinho T, Goel K, Correa de Sa D, et al. Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of “normal weight central obesity”. J Am Coll Cardiol. 2013;61:553–60.CrossRefPubMed
19.
go back to reference Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005;112:2735–52.CrossRefPubMed Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005;112:2735–52.CrossRefPubMed
20.
go back to reference Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008;61:646–53.CrossRefPubMed Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008;61:646–53.CrossRefPubMed
21.
go back to reference Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation. 2009;120:1640–5.CrossRefPubMed Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the international diabetes federation task force on epidemiology and prevention; national heart, lung, and blood institute; American heart association; world heart federation; international atherosclerosis society; and international association for the study of obesity. Circulation. 2009;120:1640–5.CrossRefPubMed
22.
go back to reference Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM. Statistics in medicine–reporting of subgroup analyses in clinical trials. N Engl J Med. 2007;357:2189–94.CrossRefPubMed Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM. Statistics in medicine–reporting of subgroup analyses in clinical trials. N Engl J Med. 2007;357:2189–94.CrossRefPubMed
23.
Metadata
Title
Comparison of Adipose Distribution Indices with Gold Standard Body Composition Assessments in the EMPA-REG H2H SU Trial: A Body Composition Sub-Study
Authors
Ian J. Neeland
Darren K. McGuire
Björn Eliasson
Martin Ridderstråle
Cordula Zeller
Hans J. Woerle
Uli C. Broedl
Odd Erik Johansen
Publication date
01-12-2015
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 4/2015
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-015-0146-7

Other articles of this Issue 4/2015

Diabetes Therapy 4/2015 Go to the issue