Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Diabetes Metab. 2014 Feb;40(1):76-81. doi: 10.1016/j.diabet.2013.10.006. Epub 2013 Nov 26.


Aim: This study aimed to explore the associations between abdominal obesity, inflammatory markers and subclinical organ damage in 740 middle-aged patients with type 2 diabetes.

Methods: Waist circumference (WC) and sagittal abdominal diameter (SAD) were measured, and blood samples were analyzed for C-reactive protein (CRP) and IL-6. Carotid intima-media thickness (IMT) was evaluated by ultrasonography, and aortic pulse wave velocity (PWV) measured with applanation tonometry.

Results: Abdominal obesity as determined by SAD and WC was significantly correlated with IL-6 (WC: r=0.27, P<0.001; SAD: r=031, P<0.001), CRP (WC: r=0.29, P<0.001; SAD: r=0.29, P<0.001), IMT (WC: r=0.09, P=0.013; SAD: r=0.11, P=0.003) and PWV (WC: r=0.18, P<0.001; SAD: r=0.21, P<0.001). In multiple linear regressions with IMT and PWV as dependent variables, and age, gender, statin use, systolic blood pressure (SBP), body mass index (BMI), CRP and HbA1c as independent variables, both SAD and WC remained associated with IMT and PWV. On stepwise linear regression and entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV.

Conclusion: Both SAD and WC are feasible measures of obesity, and both provide information on inflammation, atherosclerosis and arterial stiffness in type 2 diabetes, while SAD appears to be slightly more robustly associated with subclinical organ damage than WC.

Trial registration: ClinicalTrials.gov NCT01049737.

Keywords: Anthropometric measurements; Cardiovascular disease; Obesity; Type 2 diabetes.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / diagnostic imaging*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / physiopathology*
  • Biomarkers / metabolism
  • Body Mass Index
  • Body Size
  • C-Reactive Protein / metabolism*
  • Carotid Intima-Media Thickness
  • Diabetic Angiopathies / diagnostic imaging
  • Diabetic Angiopathies / physiopathology*
  • Female
  • Humans
  • Inflammation / complications
  • Inflammation / physiopathology*
  • Interleukin-6 / metabolism*
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications
  • Obesity, Abdominal / diagnostic imaging
  • Obesity, Abdominal / physiopathology*
  • Pulse Wave Analysis
  • Vascular Stiffness
  • Waist Circumference


  • Biomarkers
  • Interleukin-6
  • C-Reactive Protein

Associated data

  • ClinicalTrials.gov/NCT01049737