The association of insulin resistance and carotid atherosclerosis with thigh and calf circumference in patients with type 2 diabetes

A total of 4,427 subjects with type 2 diabetes were enrolled in this study. Insulin sensitivity was assessed according the rate constant for plasma glucose disappearance (Kitt) determined via the short insulin tolerance test. Biochemical and anthropometric profiles were measured according to a standardized protocol. Visceral fat thickness and carotid intima media thickness (IMT) were measured by ultrasonography.Insulin sensitivity index (Kitt) was significantly correlated with weight adjusted thigh and calf circumference. Thigh circumference was inversely associated with IMT in men and women and calf circumference was negatively correlated with IMT in women. Multiple stepwise regression analysis revealed that thigh circumference was independently correlated with insulin sensitivity index (Kitt) and IMT. Furthermore, in multivariate logistic regression analysis, thigh circumference was an independent determinant factor for carotid atherosclerosis in patients with type 2 diabetes even after adjusting for other cardiovascular risk factors.Thigh and calf circumference were correlated with insulin resistance and carotid atherosclerosis, and thigh circumference was independently associated with insulin resistance and carotid atherosclerosis in patients with type 2 diabetes.Insulin resistance is associated with increased risk of cardiovascular disease (CVD), hypertension, obesity and dyslipidemia and is related to the development of type 2 diabetes [1]. Obesity, especially abdominal obesity, may play a major role in insulin resistance and various metabolic risk factors [2-6], however, recent studies have suggested that body muscle mass is also related to insulin resistance [1,7]. As skeletal muscle is an important site of glucose uptake and deposition [8], loss of muscle mass could influence insulin sensitivity and promote metabolic disorders such as diabetes mellitus [1]. Moreover recently, peripheral adiposity in lower body was found to be associated with insulin resista