Sex differences in body composition in people with prediabetes and type 2 diabetes as compared with people with normal glucose metabolism: the Maastricht Study

Ritter, R. de; Sep, S.J.S.; Greevenbroek, M.M.J. van; Kusters, Y.H.A.M.; Vos, R.C.; Bots, M.L.; ... ; Stehouwer, C.D.A. (2023)

Article / Letter to editor

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, 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.

• Body composition
• DEXA
• Fat mass
• Lean mass
• Liver fat
• MRI
• Prediabetes
• Sex differences
• Type 2 diabetes
• Women

• All authors: Ritter, R. de; Sep, S.J.S.; Greevenbroek, M.M.J. van; Kusters, Y.H.A.M.; Vos, R.C.; Bots, M.L.; Kooi, M.E.; Dagnelie, P.C.; Eussen, S.J.P.M.; Schram, M.T.; Koster, A.; Brouwers, M.C.G.; Sangen, N.M.R. van der; Peters, S.A.E.; Kallen, C.J.H. van der; Stehouwer, C.D.A.
• Date: 2023-02-20
• Journal: Diabetologia
• Volume: 66
• Issue: 5
• Pages: 861 - 872
• DOI: doi:10.1007/s00125-023-05880-0
• Link: https://link.springer.com/article/10.1007/s00125-023-05880-0