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

Rianneke de Ritter*, Simone J.S. Sep, Marleen M.J. van Greevenbroek, Yvo H.A.M. Kusters, Rimke C. Vos, Michiel L. Bots, M. Eline Kooi, Pieter C. Dagnelie, Simone J.P.M. Eussen, Miranda T. Schram, Annemarie Koster, Martijn C.G. Brouwers, Niels M.R. van der Sangen, Sanne A.E. Peters, Carla J.H. van der Kallen, Coen D.A. Stehouwer

*Corresponding author for this work

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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, 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.].

Original languageEnglish
Pages (from-to)861-872
Number of pages12
JournalDiabetologia
Volume66
Issue number5
DOIs
Publication statusPublished - May 2023

Keywords

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

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