Association between skeletal muscle mass to visceral fat area ratio and insulin resistance in type 2 diabetes

Objective To investigate the correlation between skeletal muscle mass to visceral fat area ratio (SVR), neutrophil/lymphocyte ratio (NLR) and insulin resistance (IR) in patients with type 2 diabetes mellitus (T2DM). Methods 246 T2DM patients who attended the outpatient clinics and wards of the Department of Endocrinology of the Seventh People's Hospital affiliated to Shanghai University of Traditional Chinese Medicine from June 2022 to March 2023 were selected as study subjects. General information of the study subjects was collected, body measurements were determined: height, weight, waist circumference, hip circumference, body mass index and waist-hip ratio (WHR) were calculated; biochemical indices were determined: NLR, fasting glucose (FPG), fasting insulin (FINS), and the homeostatic modeling was evaluated. Homeostatic Model Assessment of Insulin Resistance(HOMA-IR), and calculation of insulin sensitivity index (ISI). Skeletal muscle content (ASM), body fat mass(BMI), visceral fat area(VFA), and basal metabolism were determined by multifrequency bio resistive resistance method, and SVR were calculated. 82 cases in each group (50 males and 32 females) were divided into 3 groups according to the SVR level in three equal parts. Differences between groups were analyzed by one-way ANOVA. The correlation between NLR and SVR, HOMA-IR, ISI was analyzed using Pearson/Spearman correlation. Multiple linear regression analysis was used to analyze the relationship between SVR and IR. Results Compared with the Q3 group, NLR, FINS, HOMA-IR were elevated in the Q1 and Q2 groups (P < 0.005), and ISI and SVR were decreased (P < 0.005). Correlation analysis showed that NLR was negatively correlated with SVR, and ISI (P < 0.005) and positively correlated with HOMA-IR (P < 0.005). Multiple linear regression analysis showed that SVR and HOMA-IR were independently correlated (F = 25.584,P < 0.001); and SVR and HOMA-IR were independently correlated (F = 46.105,P < 0.001). Conclusion SVR is correlated with IR in T2DM patients, suggesting that SVR has some clinical value for early warning of IR in T2DM.