Ectopic fat obesity presents the greatest risk for incident type 2 diabetes: a population-based longitudinal study

• Published in: International Journal of Obesity Vol. 43; no. 1; pp. 139 - 148
• Main Authors: Okamura, Takuro, Hashimoto, Yoshitaka, Hamaguchi, Masahide, Obora, Akihiro, Kojima, Takao, Fukui, Michiaki
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-01-2019; Nature Publishing Group
• Subjects: 692/163/2743/137/773; 692/163/2743/393; Adult; Analysis; Body Mass Index; Body size; Complications and side effects; Correlation analysis; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - etiology; Diabetes Mellitus, Type 2 - physiopathology; Diagnostic imaging; Epidemiology; Fatty liver; Female; Health Promotion and Disease Prevention; Health risk assessment; Humans; Internal Medicine; Intra-Abdominal Fat - pathology; Japan - epidemiology; Liver; Liver diseases; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Men; Metabolic Diseases; Middle Aged; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - physiopathology; Phenotypes; Population studies; Population-based studies; Prevalence studies (Epidemiology); Public Health; Risk analysis; Risk assessment; Risk Factors; Type 2 diabetes; Ultrasound; Ultrasound imaging; Japan
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/s41366-018-0076-3

Objectives
Obesity is a risk factor for type 2 diabetes mellitus. Among obesity, visceral fat obesity, and ectopic fat obesity, it has been unclear which has the greatest effect on incident diabetes.
Methods
In this historical cohort study of 8430 men and 7034 women, we investigated the effect of obesity phenotypes on incident diabetes. Obesity, visceral fat obesity, and ectopic fat obesity were defined as body mass index ≥25 kg/m
2
, waist circumference ≥90 cm in men or ≥80 cm in women, and having fatty liver diagnosed by abdominal ultrasonography, respectively. We divided the participants into eight groups according to the presence or absence of the three obesity phenotypes.
Results
During the median 5.8 years follow-up for men and 5.1 years follow-up for women, 286 men and 87 women developed diabetes. Compared to the non-obese group, the hazard ratios (HRs) of incident diabetes in the only-obesity, only-visceral fat obesity, only-ectopic fat obesity groups, and with all-three types of obesity group were 1.85 (95%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. Moreover, the risk of incident diabetes of the groups with ectopic fat obesity were almost higher than that of the four groups without ectopic fat obesity.
Conclusion
Ectopic fat obesity presented the greatest risk of incident type 2 diabetes.