Association of Various Anthropometric Indices with Sudomotor Dysfunction in Type 2 Diabetic Patients

Aim: To investigate the relationship between sudomotor dysfunction and various body composition analysis indices in type 2 diabetic patients. Methods: Between January 2016 and April 2021, 136 diabetic participants who had undergone body composition analysis (BCA) were recruited for this cross-sectional study. Sudomotor functions were assessed using SUDOSCAN, and participants were grouped into patients with normal (Group 1, n = 51), mildly reduced (Group 2, n = 46) and severely reduced (Group 3, n = 39) foot electrochemical skin conductance (FESC) levels. Results: The mean age was 60.4 ± 10.1 years, median diabetes duration was 12 (6 - 19) years, and 52.2% of participants were males. Among BCA parameters, the significant differences were found in total fat (TF) (p = 0.023), percentage of TF (%TF) (p = 0.025), percentage of android fat (%AF) (p = 0.048), fat mass (FM) in arms (p = 0.016), FM in legs (p = 0.002), appendicular fat mass (aFM) (p = 0.002), appendicular fat mass/body mass index (aFM/BMI) ratio (p = 0.009) between three groups. In Spearman correlation analysis, FESC was correlated with RBC, ESR and homocysteine (r = 0.171, r = −0.190, r = −0.192, p < 0.05), respectively. Multivariate linear regression analysis revealed that FM in arms, FM in legs, aFM and aFM/BMI ratio were independently associated with FESC even after adjustment for age, diabetes duration, WC, systolic BP, HbA1c, FPG, HOMA-IR, ESR, HDL-C, LDL-C, Total Cholesterol, ALT (β =0.161, 0.155, 0.165, 0.185, p < 0.05, respectively). Conclusion: The progressive decline of sudomotor function is positively associated with loss of subcutaneous fat in arms and legs, suggesting that subcutaneous fat of extremities may be necessary to prevent DPN progression in type 2 diabetic patients.