The Relationship between Body Fat Distribution and Diabetes Mellitus in Middle-Aged and Young Adults

<b>Objective</b>The aim of this study was to evaluate the relationship between regional body fat distribution and diabetes mellitus (DM) in young and middle-aged adults and to predict DM risk based on body fat distribution, thereby providing evidence for optimizing obesity management in this population.<b>Methods</b>Data were derived from the National Health and Nutrition Examination Survey (NHANES) from 2011–2018, which collected information on regional body fat, including fat mass and percentage in the head, arms, trunk, and legs. Restricted cubic splines (RCSs), weighted multivariable logistic regression, and sensitivity analysis were primarily used to examine the relationships between fat mass and percentage in various body regions and the risk of DM. The area under the receiver operating characteristic curve (AUC) was used to compare the predictive performance of body mass index (BMI), waist circumference (WC), and regional fat mass (RFM) for DM. Body shapes were redefined based on RFM and the upper to lower (U/L) fat ratio, and the relationships between different body shapes and DM were analyzed.