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Ectopic fat obesity poses greatest risk of type 2 diabetes

10 Feb 2019

Ectopic fat obesity carries the highest risk of developing type 2 diabetes (T2D) when compared with obesity and visceral fat obesity alone, each of which having little effect on the risk, a study has found.

Researchers examined the effect of obesity phenotypes on incident diabetes in a cohort of 8,430 men (mean age 44.1 years) and 7,034 women (mean age 43.3 years). The respective proportions of obesity (body mass index [BMI], ≥25 kg/m2), visceral (waist circumference ≥90 cm in men or ≥80 cm in women) and ectopic fat obesity (fatty liver diagnosis by abdominal ultrasonography) were 22.5 percent, 11.4 percent and 26.8 percent for men, and 8.9 percent, 14.9 percent and 6.9 percent for women.

The participants were divided into eight groups according to the presence or absence of the three obesity phenotypes.

Over a median 5.8 years follow-up for men and 5.1 years follow-up for women, 286 men and 87 women developed diabetes. Cox analysis revealed that visceral fat obesity presented a significant risk increase in incident diabetes, while obesity alone was not associated with the risk. Furthermore, the risk tended to be a lot higher in the presence vs absence of ectopic fat obesity.

The corresponding hazard ratios of incident diabetes in the obesity-only, visceral fat obesity-only, ectopic fat obesity-only and all obesity-type groups vs the nonobese group were as follows: 1.85 (95 percent CI, 1.06–3.26; p=0.05) in men and 1.79 (0.24–13.21; p=0.60) in women; 3.41 (2.51–4.64; p<0.001) in men and 2.30 (0.87–6.05; p=0.12) in women; 4.74 (1.91–11.70; p<0.001) in men and 13.99 (7.23–27.09; p<0.001) in women; and 10.5 (8.02–13.8; p<0.001) in men and 30.0 (18.0–50.0; p<0.001) in women.

The present data clearly indicate that ectopic fat obesity substantially raises the risk of developing T2D, researchers said. Therefore, efforts at prevention should focus more on the presence of the said obesity phenotype.

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