O. C. Juntila1, J. Friedman1, D. Cron1, M. Terjimanian1, M. Lindquist1, A. Hammoud1, M. Alameddine1, J. Claflin1, M. Englesbe1, S. Wang1, C. Sonnenday1 1University Of Michigan,Department Of Surgery,Ann Arbor, MI, USA
Introduction:
Risk stratification for surgical procedures is traditionally done using demographic factors, such as: age, BMI, and comorbid disease. Better methods are needed to measure body composition and assess risk in surgical patients with chronic disease. BMI, for example, is limited in describing characteristics associated with diabetes, a chronic disease with profound impact on overall health and surgical outcomes. This study aims to use analytic morphomics to describe differences in fat distribution and trunk muscle size among patients with and without diabetes.
Methods:
A retrospective cohort study was established using CT scans and associated clinical profiles of trauma patients at the University of Michigan between 2000 and 2013. The visceral fat area and lean psoas area were measured at the L4 level using established analytic morphomic techniques. Patients were stratified by gender and BMI weight categories: obese (BMI >30 kg/m²), overweight (25<BMI<30 kg/m²), and normal weight (BMI <25 kg/m²). Statistical analysis was performed to determine differences between morphomic measurements within each weight category.
Results:
We identified 1178 patients (66.7% male) with an overall presence of Type II diabetes of 9.2%. Across all male weight categories diabetics consistently had significantly greater visceral fat area than non-diabetics (obese: P=<0.001, overweight: P=0.074, normal weight: P=<0.001) and displayed significantly smaller lean psoas area when compared to non-diabetics within the same weight category (obese P=0.001, overweight P=<0.001, normal weight P=0.0056). Similarly, female diabetics showed greater visceral fat area (obese P=0.0035, overweight P=0.043, normal weight P=<0.001), and smaller lean psoas area (obese P=0.031, overweight P=0.003, normal weight P=0.18) when compared to non-diabetic females. Figure 1 compares lean psoas and visceral fat areas of diabetic and non-diabetic males across weight categories.
Conclusion:
Diabetics have greater visceral fat and smaller lean trunk muscle mass than non-diabetics. Analytic morphomics appears to offer greater characterization of body composition than that offered by BMI. Future study is needed to identify morphomic phenotypes associated with chronic disease and adverse health outcomes.
