Estimation Of Subcutaneous Fat Thickness Using Various Anthropometric Measures And Their Correlation In Type 2 Diabetes Mellitus – A One Year Cross Sectional Study

Abstract

Background and objectives Overweight and obesity leads to a number of diseases including diabetes mellitus that contribute to increased morbidity and mortality. This study was aimed to estimate subcutaneous fat thickness using various anthropometric measures like body mass index, waist hip ratio, Neck circumference, inter-scapular skin thickness and to correlate these parameters with type 2 diabetes mellitus. Methodology This one year hospital based cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2016 to December 2016. A total of 100 Patients presenting with type 2 diabetes mellitus were studied. These patients were evaluated for anthropometric measures like body mass index, waist hip ratio, Neck circumference, inter-scapular skin thickness Results Majority of patients were males amounting to 68% and 32% of the patients were females with the male female ratio of 2.12:1. the most common age group was 51 to 60 years (41%). The mean age was 58.98 ± 9.86 years. Majority of the patients (69%) had elevated fasting blood sugar levels (≥126 mg/dL). The mean FBS levels were 163.67±70.87 mg/dL. Also majority of the patients (66%) had elevated post prandial blood sugar levels (≥200 mg/dL). The mean PPBS levels were 243.16±87.75 mg/dL. 40% of the patients had HbA1c levels between 7.0-8.5 and 39% of the patients had HbA1c levels of > 8.5. The mean HbA1c levels were 8.72 ± 2.08. Most of the patients i.e., 63% were overweight (25.00-29.99 kg/m2) while 20% of the patients were obese (≥30 Kg/m2). The mean BMI was 28.34±7.28 Kg/m2. Majority of the patients (96%) had abnormal waist hip ratio. The mean WHR was 1.21 ± 0.17. 97% of the patients had abnormal waist circumference. 77% of the patients had normal inter-scapular skin thickness (<2.2) while 23% of the patients had abnormal inter-scapular skin thickness (≥2.2). The mean inter-scapular skin was 1.86±0.52. The mean waist circumference was 96.90±7.77 cms. 84% of the patients had abnormal neck circumference. The mean neck circumference was 38.33±2.25 cms. 56% of the patients had raised HOMA-IR (≥2.41). The mean HOMA IR was 4.20±4.98. The mean FBS levels (195.1 ± 79.2 mg/dL vs 123.61 ± 24.60 mg/dL; p<0.001), PPBS levels (727.60 ± 95.00 mg/dL vs 196.77 ± 47.44 mg/dL; p<0.001) compared to those with normal HOMA IR levels, HBA1c levels (9.60 ± 2.20 vs 7.65 ± 1.22; p<0.001) and neck circumference (38.9± 2.20 mg/dL vs 37.65 ± 2.14 cms; p=0.006) was significantly high in patients with insulin resistance compared to those with normal HOMA IR levels. Moderate positive correlation was observed between neck circumference with HOMA IR (r=0.4196; R2=0.1761; p<0.001), fasting blood sugar levels (r=0.4196; R2=0.1954; p<0.001), post prandial blood sugar levels (r=0.4196; R2=0.2495; p<0.001) and Glycosylated haemoglobin (r=0.4181; R2=0.1761; p<0.001) and this correlation was statistically significant. Conclusion and interpretation Neck circumference was significantly high in patients with insulin resistance compared to those with normal HOMA IR. Incidentally we also found that FBS, PPBS, HbA1c levels were high in patients with insulin resistance compared to those with normal HOMA IR levels. Also there is moderate positive correlation between neck circumference and FBS, PPBS, HbA1c and HOMA IR.