Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study
de Ritter, Rianneke; Sep, Simone J.S.; van Greevenbroek, Marleen M.J.; Kusters, Yvo H.A.M.; Vos, Rimke C.; Bots, Michiel L.; Kooi, M. Eline; Dagnelie, Pieter C.; Eussen, Simone J.P.M.; Schram, Miranda T.; Koster, Annemarie; Brouwers, Martijn C.G.; van der Sangen, Niels M.R.; Peters, Sanne A.E.; van der Kallen, Carla J.H.; Stehouwer, Coen D.A.
(2023) Diabetologia, volume 66, issue 5, pp. 861 - 872
(Article)
Abstract
Aims/hypothesis: Obesity is a major risk factor for type 2 diabetes. However, body composition differs between women and men. In this study we investigate the association between diabetes status and body composition and whether this association is moderated by sex. Methods: In a population-based cohort study (n=7639; age 40–75 years,
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50% women, 25% type 2 diabetes), we estimated the sex-specific associations, and differences therein, of prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes (reference: normal glucose metabolism [NGM]) with dual-energy x-ray absorptiometry (DEXA)- and MRI-derived measures of body composition and with hip circumference. Sex differences were analysed using adjusted regression models with interaction terms of sex-by-diabetes status. Results: Compared with their NGM counterparts, both women and men with prediabetes and type 2 diabetes had more fat and lean mass and a greater hip circumference. The differences in subcutaneous adipose tissue, hip circumference and total and peripheral lean mass between type 2 diabetes and NGM were greater in women than men (women minus men [W–M] mean difference [95% CI]: 15.0 cm2 [1.5, 28.5], 3.2 cm [2.2, 4.1], 690 g [8, 1372] and 443 g [142, 744], respectively). The difference in visceral adipose tissue between type 2 diabetes and NGM was greater in men than women (W–M mean difference [95% CI]: −14.8 cm2 [−26.4, −3.1]). There was no sex difference in the percentage of liver fat between type 2 diabetes and NGM. The differences in measures of body composition between prediabetes and NGM were generally in the same direction, but were not significantly different between women and men. Conclusions/interpretation: This study indicates that there are sex differences in body composition associated with type 2 diabetes. The pathophysiological significance of these sex-associated differences requires further study. Graphical abstract: [Figure not available: see fulltext.].
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Keywords: Body composition, DEXA, Fat mass, Lean mass, Liver fat, MRI, Prediabetes, Sex differences, Type 2 diabetes, Women, Internal Medicine, Endocrinology, Diabetes and Metabolism
ISSN: 0012-186X
Publisher: Springer-Verlag
Note: Publisher Copyright: © 2023, The Author(s).
(Peer reviewed)