[Analysis of the body composition of patients with impaired carbohydrate metabolism].

The prevalence of carbohydrate metabolism disorders, such as type 2 diabetes mellitus and insulin resistance, associated with the global obesity pandemic, makes modern healthcare necessary to improve diagnostic tools aimed at early detection and further evaluation of the effectiveness of therapeutic measures. Bioimpedance is a modern diagnostic tool in dietetics and endocrinology. Differences in body composition, as well as the accumulation of fat mass in patients with impaired carbohydrate metabolism, become an urgent issue to study. The purpose of the study was to conduct a comparative analysis of the body composition of patients with type 2 diabetes mellitus (DM2) and insulin resistance (IR).

Material and methods: The analysis of medical records of 1003 patients who received individual consultations from a dietitian and an endocrinologist at the bases of medical, preventive and diagnostic organizations in Samara has been carried out. The patients were divided into three groups depending on the disease history: with diagnosed DM2 (288 people); with clinically established IR (319 people) and without carbohydrate metabolism disorders (396 people). The data of the morbidity history and the results of bioimpedance have been analyzed.

Results: A significant difference in the component composition between patients with DM2, insulin resistance and without impaired carbohydrate metabolism was revealed in all parameters, except for active cellular and musculo-skeletal mass in kilograms and basal metabolism in women and except for the percentage of fat mass in men. DM2 patients were found to have the highest median values of body weight and body mass index (BMI), fat mass, total body water, and the lowest values of active cellular and skeletal muscle mass relative to lean body mass, as well as the current metabolic rate (specific basal metabolic rate and phase angle). The results of the component composition in patients of different sexes had a statistically significant difference (p<0.001) in patients with IR and DM2 for all indicators except body fat mass in kilograms and BMI. At the same time, in the group of patients without carbohydrate metabolism disorders, statistically significant differences were not found for any of the indicators, except for the phase angle and fat mass in kilograms, which may indicate the presence of certain gender-specific characteristics of the influence of carbohydrate metabolism disorders on the component composition of the body. Significant differences in fat mass and proportion of fat mass were found for patients with and without carbohydrate metabolism disorders depending on the body mass index. There were also significant differences in fat mass and the fat mass available for patients with and without impaired carbohydrate metabolism, depending on BMI.

Conclusion: Bioelectrical impedance analysis as a method of analyzing the body structure and nutritional status of patients is an effective and easy-to-use tool capable of detecting abnormalities in the accumulation of adipose tissue and metabolic processes in patients with impaired carbohydrate metabolism. Differences in the fat component of body composition in individuals with excess body weight and obesity in the presence and absence of DM2 and IR confirm the need to assess the body composition in patients of dietary and endocrinological profiles for early detection of these disorders and their control in view of the diabetogenic effect of adipose tissue.