Abstract
BACKGROUND: The impact of subcutaneous fat accumulation remains controversial. This study assessed the association between visceral or subcutaneous fat area (VFA and SFA, respectively) and diabetes mellitus (DM) among Japanese subjects. METHODS: This was a cross-sectional study involving 1907 eligible participants (men, 1050; women, 857) who participated in a voluntary health check-up conducted at Juntendo University Hospital from January 2017 to December 2018, in Tokyo, Japan. Associations between VFA or SFA quartiles and DM were identified using adjusted odds ratios (AORs) and 95% confidence intervals (CIs) with multivariable logistic regression analysis adjusted for confounders. Receiver operating characteristic (ROC) curve analysis was used to assess appropriate cut-off values of VFA or SFA. RESULTS: Multivariate analyses showed that Q4 (≥ 125 cm(2)) of VFA was significantly positively associated with DM compared to Q1 (< 65 cm(2)) (AOR = 1.94, 95% CI 1.02-3.71), whereas there was no association between SFA and DM in men. Among women, Q4 (≥ 85 cm(2)) of VFA was significantly positively associated with DM compared to Q1 (< 30 cm(2)) (Q4, AOR = 6.15, 95% CI 1.65-22.99). Also, Q3 and Q4 (≥ 135 cm(2)) of SFA were significantly positively associated with DM compared to Q1 (< 90 cm(2)) (Q3, AOR = 5.64, 95% CI 1.21-26.25; Q4, AOR = 7.81, 95% CI 1.71-35.65). The appropriate cut-off value of VFA in men was 101.5 cm(2). Those of VFA and SFA in women were 72.5 cm(2) and 165.3 cm(2), respectively. CONCLUSIONS: Our results suggest the importance of considering SFA as well as VFA, especially in women, for primary and secondary prevention of DM.