Body composition of type 2 diabetes patients in Uganda: A case-control study
Accepted: 28 June 2022
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Introduction: The prevalence of obesity among people diag-nosed with Type 2 Diabetes Mellitus (T2DM) has been widely documented. However, the specific composition of this body-weight remains largely unknown. The study aimed to understand the body composition of T2DM patients using the bioelectric impedance analysis technique, comparing findings to sex and age-matched controls.
Materials and Methods: A comparative case-control study was carried out among 139 known cases of Type 2 diabetes aged 18 to 78 years randomly sampled from the diabetic clinic of Mbarara Regional Referral Hospital. We matched them to 139 hos-pital controls who were healthy non-diabetic attendants. Body composition parameters were computed and summarized as medi-ans and interquartile ranges. Differences in the medians of body composition parameters were further assessed using the Mann-Whitney U test. Fat-free and fat mass indices were derived to offer a precise estimation of body composition parameters adjusted for height differences among study participants.
Results: Cases had significantly higher median systolic blood pressure, pulse rate, weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), total fat percentage, fat mass amount, Fat Mass Index, visceral fat, and metabolic age than their counterparts, whereas controls had significantly higher median total body water percentage versus cases. The highest significant differences occurred in fat percentage composition (Cases: β: 6.9 (95% C.I: 4.4, 9.4); Controls: Ref) followed by visceral fat (Cases: β: 3.5 (95% C.I: 2.5, 4.4); controls: Ref) and Fat Mass Index (Cases: 95% C.I: 2.6 (95% C.I: 1.6, 3.7). Cases had significantly higher Fat Mass Index, visceral fat and fat percentage (all p<0.05) than con-trols.
Conclusions: Routine assessment of body composition of T2DM patients needs to be done to assess the amount, type and pattern of weight gain to prevent increases in adiposity.
American Diabetes Association,. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2004 Jan 1;27(suppl 1):s5–10. DOI: https://doi.org/10.2337/diacare.27.2007.S5
Daousi C, Casson IF, Gill GV, MacFarlane IA, Wilding JPH, Pinkney JH. Prevalence of obesity in type 2 diabetes in sec-ondary care: association with cardiovascular risk factors. Postgraduate Medical Journal. 2006 Apr;82(966):280. DOI: https://doi.org/10.1136/pmj.2005.039032
Bhupathiraju SN, Hu FB. Epidemiology of Obesity and Diabetes and Their Cardiovascular Complications. Circulation research. 2016 May 27;118(11):1723. DOI: https://doi.org/10.1161/CIRCRESAHA.115.306825
Gastaldelli A, Cusi K, Pettiti M, Hardies J, Miyazaki Y, Berria R, et al. Relationship between hepatic/visceral fat and hepatic insulin resistance in nondiabetic and type 2 diabetic subjects. Gastroenterology. 2007 Aug;133(2):496–506. DOI: https://doi.org/10.1053/j.gastro.2007.04.068
Brugnara L, Murillo S, Novials A, Rojo-Martínez G, Soriguer F, Goday A, et al. Low Physical Activity and Its Association with Diabetes and Other Cardiovascular Risk Factors: A Nationwide, Population-Based Study. PLOS ONE. 2016 Aug 17;11(8):e0160959. DOI: https://doi.org/10.1371/journal.pone.0160959
Sami W, Ansari T, Butt NS, Hamid MRA. Effect of diet on type 2 diabetes mellitus: A review. Int J Health Sci (Qassim). 2017;11(2):65–71.
Chaudhury A, Duvoor C, Reddy Dendi VS, Kraleti S, Chada A, Ravilla R, et al. Clinical Review of Antidiabetic Drugs: Implications for Type 2 Diabetes Mellitus Management. Front Endocrinol [Internet]. 2017 [cited 2021 Apr 3];8. Available from: https://www.frontiersin.org/articles/10.3389/fendo.2017. 00006/full DOI: https://doi.org/10.3389/fendo.2017.00006
Matovu N, Matovu FK, Sseguya W, Tushemerirwe F. Association of dietary intake and BMI among newly diagnosed type 2 diabetes patients attending diabetic clinics in Kampala. BMC Nutr. 2017 Dec;3(1):1–10. DOI: https://doi.org/10.1186/s40795-017-0141-7
Alshehri AM. Metabolic syndrome and cardiovascular risk. J Family Community Med. 2010;17(2):73–8. DOI: https://doi.org/10.4103/1319-1683.71987
Genton L, Graf CE, Karsegard VL, Kyle UG, Pichard C. Low fat-free mass as a marker of mortality in community-dwelling healthy elderly subjects†. Age and Ageing. 2013 Jan 1;42(1):33–9. DOI: https://doi.org/10.1093/ageing/afs091
Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. Validity of the Global Physical Activity Questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014 Dec 10;14(1):1255. DOI: https://doi.org/10.1186/1471-2458-14-1255
Nsamba J, Lule SA, Namara B, Zziwa C, Akurut H, Lubyayi L, et al. Effect of birth weight, exclusive breastfeeding and growth in infancy on fat mass and fat free mass indices in early adolescence: an analysis of the Entebbe Mother and Baby Study (EMaBs) cohort. AAS Open Res. 2020 Jan 9;2:11. DOI: https://doi.org/10.12688/aasopenres.12947.2
Owolabi LF, Adebisi S, Danborno B. Nigerian Journal of. 2016;(January).
Abulmeaty MMA, Aljuraiban GS. Body Composition and the Components of Metabolic Syndrome in Type 2 Diabetes : The Roles of Disease Duration and Glycemic Control. 2020;1051–9. DOI: https://doi.org/10.2147/DMSO.S248842
Solanki JD, Makwana AH, Mehta HB, Gokhale PA, Shah CJ. Body Composition in Type 2 Diabetes : Change in Quality and not Just Quantity that Matters. 2015. DOI: https://doi.org/10.4103/2008-7802.172376
Grossman A, Grossman E. Blood pressure control in type 2 diabetic patients. Cardiovascular Diabetology. 2017;1–15. DOI: https://doi.org/10.1186/s12933-016-0485-3
Supporting AgenciesMbarara University of Science and Technology, Mbarara Regional Referral Hospital, Hansjoerg Wyss and Massachusetts General Hospital.
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