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Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Copyright © 2020 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: C.H.J., J.O.M. Acquisition, analysis, or interpretation of data: C.H.J., D.C., B.Y.K. Drafting the work or revising: C.H.J., Y.Y.C., C.H.K., J.O.M. Final approval of the manuscript: J.O.M.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range).
DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; Rt., right; SPP, skin perfusion pressure; Lt., left; HbA1c, glycated hemoglobin; eGFR, estimated glomerular filtration rate; MDRD, Modification of Diet in Renal Disease; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ABI, ankle-brachial index; PWV, pulse wave velocity; ASM, appendicular skeletal muscle; OHA, oral hypoglycemic agent.
The lower of the two SPP values measured at both the dorsal and plantar surfaces of each foot was taken as the SPP.
SPP, skin perfusion pressure; ASM, appendicular skeletal muscle; Rt., right; Lt., left; DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; HbA1c, glycated hemoglobin; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ABI, ankle-brachial index; PWV, pulse wave velocity.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range).
SPP, skin perfusion pressure; DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; eGFR, estimated glomerular filtration rate; Rt., right; ABI, ankle-brachial index; Lt., left; PWV, pulse wave velocity; HbA1c, glycated hemoglobin; ASM, appendicular skeletal muscle; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; OHA, oral hypoglycemic agent.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range).
DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; eGFR, estimated glomerular filtration rate; ABI, ankle-brachial index; PWV, pulse wave velocity; HbA1c, glycated hemoglobin; ASM, appendicular skeletal muscle; SPP, skin perfusion pressure; Rt., right; Lt., left; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; OHA, oral hypoglycemic agent.
OR | 95% CI | P value | |
---|---|---|---|
Model 1 | 4.0 | 1.02–15.7 | 0.047 |
Model 2 | 4.8 | 1.11–20.8 | 0.036 |
Model 3 | 4.1 | 1.01–24.9 | 0.048 |
Variable | Total (n=102) |
---|---|
Age, yr | 55.9±9.8 |
| |
Male sex | 115 (63.7) |
| |
Duration of DM, yr | 9 (2.4–15.3) |
| |
Current smoking | 15 (15.6) |
| |
Alcohol | 36 (37.5) |
| |
BMI, kg/m2 | 26.0±3.1 |
| |
VFT, cm | 41.5±16.3 |
| |
SFT, cm | 15.5±5.1 |
| |
Rt. dorsal SPP | 71.0±14.1 |
| |
Lt. dorsal SPP | 76.2±13.1 |
| |
Rt. plantar SPP | 74.4±12.7 |
| |
Lt. plantar SPP | 77.5±12.6 |
| |
HbA1c, mmol/mol (%) | 91±9 (7.6±2.0) |
| |
eGFR, mL/min/1.73 m2 (MDRD) | 69.7±15.3 |
| |
Total cholesterol, mg/dL | 155±34 |
| |
LDL-C, mg/dL | 83±28 |
| |
HDL-C, mg/dL | 47±16 |
| |
Triglycerides, mg/dL | 127 (96–184) |
| |
Mean ABI | 1.15±0.08 |
| |
Mean PWV | 1,609±717 |
| |
ASM/height, kg/m2 | 7.9±1.2 |
| |
Sarcopenia | 12 (11.8) |
| |
Treatment modality | |
Diet only | 1 (1.0) |
OHA | 78 (76.5) |
OHA and insulin | 18 (17.6) |
Insulin only | 5 (4.9) |
| |
Statin | 80 (78.4) |
| |
Antiplatelet agent | 53 (51.9) |
| |
Rt. side dorsal or plantar SPP below 50% | 13 (12.7) |
| |
Lt. side dorsal or plantar SPP below 50% | 3 (2.9) |
| |
Any-side dorsal or plantar SPP below 50% | 14 (13.7) |
Variable | r (P value) | ||
---|---|---|---|
ASM/height | Rt. SPP | Lt. SPP | |
ASM/height | - | 0.198 (0.041) | 0.155 (0.120) |
Rt. SPP | 0.198 (0.041) | - | 0.512 (<0.001) |
Lt. SPP | 0.155 (0.120) | 0.512 (<0.001) | - |
Age, yr | −0.359 (<0.001) | −0.188 (0.059) | −0.166 (0.096) |
Duration of DM, yr | −0.157 (0.115) | −0.122 (0.222) | −0.165 (0.098) |
BMI, kg/m2 | 0.458 (<0.001) | 0.031 (0.754) | 0.152 (0.128) |
VFT, cm | 0.208 (0.05) | −0.015 (0.888) | 0.107 (0.318) |
SFT, cm | 0.203 (0.057) | −0.071 (0.507) | 0.168 (0.116) |
HbA1c, mmol/mol | −0.055 (0.591) | −0.157 (0.122) | −0.119 (0.243) |
eGFR, mL/min/1.73 m2 | −0.072 (0.470) | −0.064 (0.526) | −0.087 (0.387) |
Total cholesterol, mg/dL | −0.064 (0.535) | −0.068 (0.510) | 0.242 (0.018) |
LDL-C, mg/dL | −0.009 (0.939) | 0.031 (0.800) | 0.241 (0.043) |
HDL-C, mg/dL | −0.304 (0.005) | −0.204 (0.062) | −0.130 (0.239) |
Triglycerides, mg/dL | 0.179 (0.084)) | 0.020 (0.850) | 0.142 (0.173)) |
Rt. ABI | −0.110 (0.288) | −0.090 (0.387) | 0.018 (0.864) |
Lt. ABI | −0.122 (0.239) | −0.086 (0.410) | −0.063 (0.543) |
Mean PWV | −0.070 (0.500) | 0.057 (0.580) | 0.035 (0.734) |
Characteristic | SPP >50 (n=88) | SPP ≤50 (n=14) | P value |
---|---|---|---|
Age, yr | 55.3±10.2 | 59.7±6 | 0.111 |
| |||
Male sex | 60 (68.2) | 5 (35.7) | 0.022 |
| |||
Duration of DM, yr | 9 (2–14.8) | 8.8 (2.9–18.3) | 0.642 |
| |||
Smoking | 14 (17.1) | 1 (7.1) | 0.311 |
| |||
Alcohol | 36 (43.9) | 0 | 0.001 |
| |||
BMI, kg/m2 | 26.2±3.1 | 24.6±3.1 | 0.074 |
| |||
VFT, cm | 42.1±16.4 | 37.5±16.3 | 0.370 |
| |||
SFT, cm | 15.6±5.1 | 14.8±5.2 | 0.649 |
| |||
eGFR, mL/min/1.73 m2 | 69±15 | 74±18 | 0.262 |
| |||
Rt. ABI | 1.14±0.09 | 1.18±0.08 | 0.105 |
| |||
Lt. ABI | 1.16±0.09 | 1.19±0.08 | 0.118 |
| |||
Mean PWV | 1,619±764 | 1,555±278 | 0.767 |
| |||
HbA1c | 7.6±2.0 | 7.7±1.6 | 0.939 |
| |||
ASM/height, kg/m2 | 8.0±1.2 | 7.3±1.1 | 0.056 |
| |||
Sarcopenia | 8 (9.1) | 4 (28.6) | 0.036 |
| |||
Statin | 70 (79.5) | 10 (71.4) | 0.493 |
| |||
Antiplatelet agent | 43 (48.9) | 10 (71.4) | 0.116 |
| |||
Total cholesterol, mg/dL | 155.8±34.7 | 150±31.7 | 0.583 |
| |||
LDL-C, mg/dL | 84.2±28 | 75.9±23.9 | 0.401 |
| |||
HDL-C, mg/dL | 47.1±17.2 | 49.2±10.4 | 0.693 |
| |||
Triglycerides, mg/dL | 127 (97–183) | 100 (86–199) | 0.799 |
| |||
Treatment modality | 0.357 | ||
No medication | 1 (1.1) | 0 | |
OHA only | 68 (77.3) | 10 (71.4) | |
OHA and insulin | 16 (18.2) | 2 (14.3) | |
Insulin only | 3 (3.4) | 2 (14.3) |
Characteristic | Sarcopenia (−) (n=90) | Sarcopenia (+) (n=12) | P value |
---|---|---|---|
Age, yr | 55.2±10.1 | 60.9±6.3 | 0.059 |
| |||
Male sex | 57 (63.3) | 8 (66.7) | 0.546 |
| |||
Duration of DM, yr | 9.3 (2–16) | 7 (3.1–13.3) | 0.642 |
| |||
Smoking | 14 (16.7) | 1 (8.3) | 0.404 |
| |||
Alcohol | 34 (40.5) | 2 (16.7) | 0.098 |
| |||
BMI, kg/m2 | 26.2±3.1 | 24.5±2.8 | 0.071 |
| |||
VFT, cm | 41.7±16.3 | 39.5±17.1 | 0.666 |
| |||
SFT, cm | 15.9±5.3 | 12.4±2.5 | 0.001 |
| |||
eGFR, mL/min/1.73 m2 | 69±15 | 72±21 | 0.614 |
| |||
Mean ABI | 1.15±0.09 | 1.17±0.07 | 0.428 |
| |||
Mean PWV | 1,640±752 | 1,377±269 | 0.255 |
| |||
HbA1c | 7.7±2.0 | 7.1±1.7 | 0.309 |
| |||
ASM/height, kg/m2 | 8.2±1 | 5.8±0.9 | 0.063 |
| |||
Any-side dorsal or plantar SPP below 50 | 8 (9.1) | 4 (28.6) | 0.036 |
| |||
Rt. dorsal SPP | 71.4±13.8 | 67.8±16 | 0.402 |
| |||
Lt. dorsal SPP | 76.7±12.9 | 72.1±3.9 | 0.244 |
| |||
Rt. plantar SPP | 75.5±12.1 | 66.1±4.2 | 0.014 |
| |||
Lt. plantar SPP | 78.2±12.6 | 72.3±12 | 0.131 |
| |||
Statin | 70 (77.8) | 10 (83.3) | 0.497 |
| |||
Antiplatelet agent | 48 (53.3) | 5 (41.7) | 0.325 |
| |||
Total cholesterol, mg/dL | 155.8±35.2 | 148±22.2 | 0.529 |
| |||
LDL-C, mg/dL | 83.7±28.6 | 78.6±16.1 | 0.626 |
| |||
HDL-C, mg/dL | 47.3±16.8 | 48.3±11.2 | 0.875 |
| |||
Triglycerides, mg/dL | 127 (96–183) | 145 (99–205) | 0.809 |
| |||
Treatment modality | 0.033 | ||
No medication | 0 | 1 (8.3) | |
OHA only | 70 (77.8) | 8 (66.7) | |
OHA and insulin | 15 (16.7) | 3 (25) | |
Insulin only | 5 (5.6) | 0 |
OR | 95% CI | P value | |
---|---|---|---|
Model 1 | 4.0 | 1.02–15.7 | 0.047 |
Model 2 | 4.8 | 1.11–20.8 | 0.036 |
Model 3 | 4.1 | 1.01–24.9 | 0.048 |
Values are expressed as mean±standard deviation, number (%), or median (interquartile range). DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; Rt., right; SPP, skin perfusion pressure; Lt., left; HbA1c, glycated hemoglobin; eGFR, estimated glomerular filtration rate; MDRD, Modification of Diet in Renal Disease; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ABI, ankle-brachial index; PWV, pulse wave velocity; ASM, appendicular skeletal muscle; OHA, oral hypoglycemic agent.
The lower of the two SPP values measured at both the dorsal and plantar surfaces of each foot was taken as the SPP. SPP, skin perfusion pressure; ASM, appendicular skeletal muscle; Rt., right; Lt., left; DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; HbA1c, glycated hemoglobin; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; ABI, ankle-brachial index; PWV, pulse wave velocity.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range). SPP, skin perfusion pressure; DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; eGFR, estimated glomerular filtration rate; Rt., right; ABI, ankle-brachial index; Lt., left; PWV, pulse wave velocity; HbA1c, glycated hemoglobin; ASM, appendicular skeletal muscle; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; OHA, oral hypoglycemic agent.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range). DM, diabetes mellitus; BMI, body mass index; VFT, visceral fat thickness; SFT, subcutaneous fat thickness; eGFR, estimated glomerular filtration rate; ABI, ankle-brachial index; PWV, pulse wave velocity; HbA1c, glycated hemoglobin; ASM, appendicular skeletal muscle; SPP, skin perfusion pressure; Rt., right; Lt., left; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; OHA, oral hypoglycemic agent.
Model 1: no adjustment; Model 2: model 1 plus sex; Model 3: model 2 plus age, smoking, diabetes mellitus duration, glycated hemoglobin, statin treatment, and antiplatelet agent treatment. SPP, skin perfusion pressure; OR, odds ratio; CI, confidence interval.