Association between skeletal muscle mass to visceral fat area ratio and arterial stiffness in Chinese patients with type 2 diabetes mellitus

Background: The skeletal muscle mass-to-visceral fat area ratio (SVR) has been linked to arterial stiffness in non-diabetic adults. We examined the association between the SVR and arterial stiffness in patients with type 2 diabetes mellitus (T2DM). Methods: Patients with type 2 diabetes mellitus (252 men and 171 women) aged 40-75 years were enrolled and divided into three groups according to SVR tertiles. Arterial stiffness was measured as brachial-ankle pulse wave velocity (baPWV), with baPWV> 1800 mm/s defined as high. Spearman's partial correlation was used to adjust confounding factors. The odds ratio for high baPVW was determined by multiple logistic regression analyses, and receiver-operating characteristic analysis was conducted. Results: SVR was associated with baPWV in Chinese patients with T2DM (Spearman's partial correlation = - 0.129, P < 0.01). SVR was found to be significantly associated with baPVW on multiple logistic regression analysis. Patients in the lower SVR tertiles had a higher OR than did those in the higher SVR tertiles, after adjusting for multiple covariates (Q1: OR =433 in men and 4.66 in women; Q3: OR = 1). The area under the curve for SVR was significantly greater than that for appendicular skeletal muscle (ASM), ASM/height(2), and visceral fat area (VAF) for identifying high baPVW (0.747 in men and 0.710 in women). The optimal cutoffs values of SVR for detecting high baPWV were 191.7 g/cm(2) for men and 1573 g/cm(2) for women. Conclusions: SVR has an independent, negative association with arterial stiffness, and is a better risk-assessment tool than ASM, ASM/height(2), and VFA in clinical practice to identify patients with type 2 diabetes at high cardiovascular risk.