Association between trunk and leg fat and incidence of diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 677-696-Obesity Physiology & Epidemiology
Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-678
Yoshimi Tatsukawa*1, Michiko Yamada2, Saeko Fujiwara3, Waka Ohishi2 and Shuhei Nakanishi4
1Radiation Effects Research Found, Hiroshima, Japan, 2Radiation Effects Research Foundation, Hiroshima, Japan, 3Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan, 4Hiroshima University, Japan
Background: General obesity defined by body mass index (BMI) is a major risk factor of diabetes mellitus (DM). Although body fat distribution is also considered to be a predictor of DM, only a few longitudinal studies have examined the association between DM risk and body composition, estimated directly using such methods as DEXA, in particular with reference to Asian populations who have a higher prevalence of DM at lower BMI levels compared with Caucasians. Objective: To determine whether fat distribution is associated with DM incidence, independently of BMI, in an elderly Japanese population. Methods: We analyzed 1,550 subjects without DM (472 men and 1,078 women, average age of 65.3 years) in the Adult Health Study, consisting of atomic bomb survivors and their controls, whose body composition was measured using DEXA during the period 1994-96. Fat-mass percentages for the trunk and legs were calculated by dividing each of the specific body part’s fat mass by total soft tissue mass. DM was defined as glucose ≥126mg/dl fasting or ≥200mg/dl nonfasting, or physician-diagnosed DM, or the use of medication for DM. We followed-up through the end of 2011. Results: During a mean follow-up period of 11.4 years, 85 men and 110 women developed DM. Almost 20% of men and 28% of women were overweight/obese (BMI≥25kg/m2) at baseline. After multivariate analysis with adjustment made for age, metabolic syndrome risk factors other than central obesity, radiation dose, and smoking and alcohol consumption status, only overweight/obese women had a significant association with DM incidence compared with non-obese women (relative risk [RR] 1.52; 95% CI 1.01-2.27). Percentages of trunk fat and leg fat were associated with incidence of DM, independently of each other, after adjustment for age, BMI, and other risk factors. Increased percentage of trunk fat was a significant risk factor for incidence of DM; the RR for 1% increase in trunk fat were 1.13 (95% CI 1.06-1.20) in men and 1.08 (95% CI 1.02-1.14) in women, whereas, leg fat had protective effects regarding incidence of DM (men RR 0.83; 95% CI 0.71-0.96, women RR 0.87; 95% CI 0.79-0.95, for 1% increase in leg fat). These significant associations were observed for non-obese subjects. Conclusion: Trunk and leg fat were associated with incidence of DM, independently of each other. In addition to evaluation of general and abdominal obesity, the assessment of body fat distribution might also be useful in the prevention of DM.

Nothing to Disclose: YT, MY, SF, WO, SN

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