Abstract
Obesity and abdominal obesity contribute to significant metabolic health risks through distinct pathophysiological mechanisms. We conducted an epigenome-wide association study to identify differential DNA methylation patterns associated with body mass index (BMI)-defined and abdominal obesity and explore their relationships with dietary intake among Korean adults (n = 1,526). We identified 23 and 1931 DMPs associated with abdominal obesity and severe BMI-defined obesity, respectively, with four CpG sites common to both phenotypes. The most significant associations were at cg10323433 and cg10501210 in serotonin receptor 2 A (HTR2A) for abdominal obesity (Δβ = -0.023) and BMI-defined obesity (Δβ = -0.021), respectively. Most DMPs (> 75%) exhibited hypomethylation in obesity with progressive changes correlating with obesity severity. Hierarchical clustering revealed distinct dietary associations: WHR-related DMPs correlated with traditional fermented foods, whereas BMI-related DMPs showed stronger associations with fruit consumption. Sites with hypomethylation in obesity consistently demonstrated positive correlations with fat intake but negative correlations with carbohydrates. The distinct associations between methylation patterns and dietary components suggest that different foods may influence epigenetic modifications that are specific to overall adiposity or fat distribution, providing potential targets for nutritional interventions to modify obesity-related epigenetic signatures.