Sex Differences of Visceral Fat Area and Visceral-to-Subcutaneous Fat Ratio for the Risk of Incident Type 2 Diabetes Mellitus

• Published in: Diabetes & metabolism journal Vol. 46; no. 3; pp. 486 - 498
• Main Authors: Kim, Eun Hee, Kim, Hong-Kyu, Lee, Min Jung, Bae, Sung-Jin, Choe, Jaewon, Jung, Chang Hee, Kim, Chul-Hee, Park, Joong-Yeol, Lee, Woo Je
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.05.2022; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Antidiabetics; Body composition; Body mass index; Chi-square test; Cholesterol; Diabetes; diabetes mellitus, type 2; Exercise; Gender differences; Glucose; Insulin resistance; intra-abdominal fat; Laboratories; Longitudinal studies; Medical imaging; Obesity; Original; Physical fitness; Population; Questionnaires; subcutaneous fat; tomography; Variance analysis; Womens health; 내과학; United States > US; Japan; Subcutaneous fat; Tomography; Intra-abdominal fat; Diabetes mellitus, type 2
• ISSN: 2233-6079; 2233-6087; 2233-6087
• DOI: 10.4093/dmj.2021.0095

Background: This study aimed to determine the optimal cut-off values of visceral fat area (VFA) and visceral-to-subcutaneous fat ratio (VSR) for predicting incident type 2 diabetes mellitus (T2DM).Methods: A total of 10,882 individuals (6,835 men; 4,047 women) free of T2DM at baseline aged between 30 and 79 years who underwent abdominal computed tomography scan between 2012 and 2013 as a part of routine health check-ups were included and followed. VFA, subcutaneous fat area, and VSR on L3 vertebral level were measured at baseline.Results: During a median follow-up of 4.8 years, 730 (8.1% for men; 4.3% for women) incident cases of T2DM were identified. Receiver operating characteristic curve analysis showed that the optimal cut-off values of VFA and VSR for predicting incident T2DM were 130.03 cm2 and 1.08 in men, respectively, and 85.7 cm2 and 0.48 in women, respectively. Regardless of sex, higher VFA and VSR were significantly associated with a higher risk of incident T2DM. Compared with the lowest quartiles of VFA and VSR, the highest quartiles had adjusted odds ratios of 2.62 (95% confidence interval [CI], 1.73 to 3.97) and 1.55 (95% CI, 1.14 to 2.11) in men, respectively, and 32.49 (95% CI, 7.42 to 142.02) and 11.07 (95% CI, 3.89 to 31.50) in women, respectively.Conclusion: Higher VFA and VSR at baseline were independent risk factors for the development of T2DM. Sex-specific reference values for visceral fat obesity (VFA ≥130 cm2 or VSR ≥1.0 in men; VFA ≥85 cm2 or VSR ≥0.5 in women) are proposed for the prediction of incident T2DM.