Data from: Ectopic fat obesity presents the greatest risk for incident type 2 diabetes: a population-based longitudinal study

Objectives: Obesity is a risk factor for type 2 diabetes mellitus. Among obesity, visceral fat obesity, and ectopic fat obesity, it has been unclear which has the greatest effect on incident diabetes.

Methods: In this historical cohort study of 8430 men and 7034 women, we investigated the effect of obesity phenotypes on incident diabetes. Obesity, visceral fat obesity, and ectopic fat obesity were defined as body mass index ≥25 kg/m2, waist circumference ≥90 cm in men or ≥80 cm in women, and having fatty liver diagnosed by abdominal ultrasonography, respectively. We divided the participants into eight groups according to the presence or absence of the three obesity phenotypes.

Results: During the median 5.8 years follow-up for men and 5.1 years follow-up for women, 286 men and 87 women developed diabetes. Compared to the non-obese group, the hazard ratios (HRs) of incident diabetes in the only-obesity, only-visceral fat obesity, only-ectopic fat obesity groups, and with all-three types of obesity group were 1.85 (95%CI 1.06–3.26, p = 0.05) in men and 1.79 (0.24–13.21, p = 0.60) in women, 3.41 (2.51–4.64, p < 0.001) in men and 2.30 (0.87–6.05, p = 0.12) in women, 4.74 (1.91–11.70, p < 0.001) in men and 13.99 (7.23–27.09, p < 0.001) in women and 10.5 (8.02–13.8, p < 0.001) in men and 30.0 (18.0–50.0, p < 0.001) in women. Moreover, the risk of incident diabetes of the groups with ectopic fat obesity were almost higher than that of the four groups without ectopic fat obesity.

Conclusion: Ectopic fat obesity presented the greatest risk of incident type 2 diabetes.

研究目的：肥胖是2型糖尿病的危险因素。在全身性肥胖、内脏脂肪型肥胖与异位脂肪型肥胖中，何者对新发糖尿病的影响最为显著，目前尚无定论。
研究方法：本研究纳入8430名男性与7034名女性开展回顾性队列研究，探讨不同肥胖表型对新发糖尿病的影响。分别以身体质量指数（Body Mass Index）≥25 kg/m²、男性腰围≥90 cm或女性腰围≥80 cm、经腹部超声（abdominal ultrasonography）诊断为脂肪肝（fatty liver），定义全身性肥胖、内脏脂肪型肥胖与异位脂肪型肥胖。本研究根据三种肥胖表型的有无，将受试者划分为8个组别。
研究结果：男性受试者中位随访时长为5.8年，女性受试者为5.1年，期间共有286名男性与87名女性新发糖尿病。以非肥胖组为参照，仅全身性肥胖组、仅内脏脂肪型肥胖组、仅异位脂肪型肥胖组以及同时合并三种肥胖表型组的新发糖尿病风险比（Hazard Ratio, HR）分别为：男性1.85（95%置信区间[CI] 1.06~3.26，p=0.05）、女性1.79（0.24~13.21，p=0.60）；男性3.41（2.51~4.64，p<0.001）、女性2.30（0.87~6.05，p=0.12）；男性4.74（1.91~11.70，p<0.001）、女性13.99（7.23~27.09，p<0.001）；男性10.5（8.02~13.8，p<0.001）、女性30.0（18.0~50.0，p<0.001）。此外，合并异位脂肪型肥胖的各组新发糖尿病风险，均显著高于未合并异位脂肪型肥胖的4个组别。
研究结论：异位脂肪型肥胖对2型糖尿病新发的风险贡献最大。