title: Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity.
abstract: BACKGROUND
  Although many Asian type 2 diabetic patients have been considered to be not obese and have low capacity of insulin secretion, the proportion of obese patients with visceral fat accumulation has increased in recent years. We found previously considerable number of Japanese non-obese subjects (body mass index (BMI) < 25 kg/m²) with visceral fat accumulation and multiple cardiovascular risk factors. The aim of the study was to investigate the difference in clinical features of type 2 diabetic patients with and without visceral fat accumulation, focusing on vascular complications and changes in BMI.
  
  
  METHODS
  We enrolled 88 Japanese hospitalized type 2 diabetic patients. Abdominal obesity represented waist circumference (WC) of ≥85 cm for males and ≥90 cm for females (corresponding to visceral fat area of 100 cm²). Subjects were divided into two groups; with or without abdominal obesity.
  
  
  RESULTS
  Hypertension, dyslipidemia and cardiovascular diseases were significantly more in the patients with abdominal obesity. The prevalence of cardiovascular disease in the non-obese patients (BMI < 25 kg/m²) with abdominal obesity were similar in obese patients (BMI ≥25 kg/m²). The mean BMI of the patients with abdominal obesity was < 25 kg/m² at 20 years of age, but reached maximum to more than 30 kg/m² in the course. Furthermore, substantial portion of the type 2 diabetic patients (52% in males and 43% in females) were not obese at 20 year-old (BMI < 25 kg/m²), but developed abdominal obesity by the time of admission.
  
  
  CONCLUSIONS
  These results emphasize the need to control multiple risk factors and prevent atherosclerotic disease in patients with abdominal obesity. The significant weight gain after 20 years of age in patients with abdominal obesity stresses the importance of lifestyle modification in younger generation, to prevent potential development of type 2 diabetes and future atherosclerotic cardiovascular disease.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nagao
authors.forename: Susumu
authors.initials: S
authors.lastname: Kashine
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nishizawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.forename: Takekazu
authors.initials: T
authors.lastname: Kimura
authors.forename: Ayumu
authors.initials: A
authors.lastname: Hirata
authors.forename: Shiro
authors.initials: S
authors.lastname: Fukuda
authors.forename: Junji
authors.initials: J
authors.lastname: Kozawa
authors.forename: Norikazu
authors.initials: N
authors.lastname: Maeda
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Tetsuyuki
authors.initials: T
authors.lastname: Yasuda
authors.forename: Kohei
authors.initials: K
authors.lastname: Okita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hibuse
authors.forename: Mamiko
authors.initials: M
authors.lastname: Tsugawa
authors.forename: Akihisa
authors.initials: A
authors.lastname: Imagawa
authors.forename: Tohru
authors.initials: T
authors.lastname: Funahashi
authors.forename: Iichiro
authors.initials: I
authors.lastname: Shimomura
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology; D050154:Adiposity / Q000208:ethnology; D000328:Adult; D000367:Age Factors; D044466:Asian People; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000208:ethnology*; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference / Q000208:ethnology; D015430:Weight Gain; D055815:Young Adult