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Impact of visceral adiposity on glycemic variability in patients with insulin-treated type 2 diabetes undergoing hemodialysis 认领 引用
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作者 Pedro Gil-Millán Ascensión Lupiañez +6 位作者 Sonia Caparrós Alicia Ribas Shaira Martínez-Vaquera Ángel Ortiz-Zuñiga Cristina Hernández Rafael Simó Olga Simó-Servat 《World Journal of Diabetes》 SCIE 2026年第3期151-161,共11页
BACKGROUND Glycemic variability(GV)is increasingly recognized as a major metabolic risk in patients with type 2 diabetes(T2D)undergoing hemodialysis(HD);however,key contributors remain unclear.AIM To identify clinical... BACKGROUND Glycemic variability(GV)is increasingly recognized as a major metabolic risk in patients with type 2 diabetes(T2D)undergoing hemodialysis(HD);however,key contributors remain unclear.AIM To identify clinical predictors of GV–measured by differences in time in range(ΔTIR)–between HD and off-HD days in patients with insulin-treated T2D.METHODS In this prospective study,35 patients with insulin-treated T2D on online HD were monitored using continuous glucose monitoring over 20 days.Glucometric variables included mean glucose,TIR,and glucose management indicator.Patients were stratified byΔTIR into low(5%)fluctuation groups.Body composition was assessed using multifrequency bioelectrical impedance analysis,including visceral fat area(VFA),skeletal muscle index,and extracellular-to-total body water ratio.RESULTS Patients withΔTIR>5%showed higher glucose levels(HD:187.1±44.3 mg/dL;off-HD:201.9±52.3 mg/dL),reduced TIR,elevated glucose management indicator(8.02%±1.14%),and significantly lower VFA(63.4±42.7 cm2 vs 127.0±49.5 cm2;P=0.001).Skeletal muscle index and hydration parameters were not different.VFA independently predictedΔTIR>5%(odds ratio=0.077;P=0.016),and a VFA threshold of approximately 63 cm²yielded 88%sensitivity and 67%specificity(area under the curve of 0.812;P=0.003).CONCLUSION VFA is a strong independent marker of GV in patients with insulin-treated T2D on HD,supporting body composition profiling in this population. 展开更多
关键词 Type 2 diabetes Hemodialysis Visceral adiposity Continuous glucose monitoring Time in range Glycemic stability Body composition Metabolic fragility
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