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Title: Altered body composition in type 2 diabetes mellitus

Author
item HESHKA, S - ST LUKE'S-ROOSEVELT HOSP
item RUGGIERO, A - WAKE FOREST UNIV SCH MED
item BRAY, G - LOUISIANA ST UNIV SYSTEM
item Foreyt, John
item KAHN, S - UNIV WASHINGTON
item LEWIS, C - UNIV ALABAMA
item SAAD, M - STATE UNIV NY
item SCHWARTZ, A - UNIV CA SAN FRANCISCO

Submitted to: International Journal of Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/30/2007
Publication Date: 5/1/2008
Citation: Heshka, S., Ruggiero, A., Bray, G.A., Foreyt, J., Kahn, S.E., Lewis, C.E., Saad, M., Schwartz, A.V. 2008. Altered body composition in type 2 diabetes mellitus. International Journal of Obesity. 32(5):780-787.

Interpretive Summary: This study examined differences in the distribution and amount of fat and lean soft tissue in overweight subjects with and without type 2 diabetes. The results indicate that subjects with type 2 diabetes had less total body fat and more whole-body lean mass than those without type 2 diabetes. Although those with type 2 diabetes had less total fat mass, both their trunk fat and trunk lean mass were greater than subjects without diabetes. Additionally, subjects with type 2 diabetes had less leg fat mass and lean mass than the healthy subjects. Women with diabetes had greater arm fat compared to healthy subjects while there was no difference among men with regard to arm fat. The finding of a larger amount of fat in the trunk region in subjects with type 2 diabetes is supported by larger epidemiological studies. Also, the finding of less leg fat in diabetic subjects is consistent with the recent notion that fat deposits in the lower region of the body may be protective for the development of diabetes and risk for cardiovascular disease. The authors suggest that further investigation is needed regarding the physiological processes producing these deviations in tissue distribution and their metabolic significance.

Technical Abstract: The styd objectives were to identify differences in amount and distribution of fat and lean soft tissue in a cross-sectional study of subjects with and without type 2 diabetes, and to determine whether any differences are affected by race/ethnicity or sex. Participants were overweight and obese (body mass index, BMI > or = 25 kg m(-2)) Black, White and Hispanic men (490) and women (825) with type 2 diabetes ((mean+/-s.d.) age 58.5+/-6.6; BMI 35.3+/-5.3) who had a baseline dual energy X-ray absorptiometry whole-body scan at the time of enrollment in the Look AHEAD clinical trial, and 242 healthy controls, 91 males and 151 females (age 55.3+/-8.6 years, BMI 30.7+/-4.2 kg m(-2)) who were participating in unrelated research and were scanned on the same densitometers. Adjusted for gender, age, race, clinical site, and body size, total fat mass was smaller in persons with type 2 diabetes than in controls (-1.4+/-0.3 (s.e.); 34.5 vs 35.8 kg, P<0.001) while trunk fat was larger (1.3+/-0.2 (s.e.); 19.9 vs 18.6 kg, P<0.001) and leg fat was smaller (-1.5+/-0.2 (s.e.); 10.7 vs 12.3 kg, P<0.001). The arms of subjects with type 2 diabetes did not have significantly less fat compared to controls. Adjusted trunk lean mass was larger in type 2 diabetes by 0.6 kg (28.4 vs 27.8 kg, P<0.001) while leg lean mass was smaller by 0.5 kg (18.1 vs 18.6 kg, P<0.001). Type 2 diabetes is associated with less total fat, leg fat, and leg lean mass and more truncal fat and lean mass than controls. The physiological processes producing these deviations in tissue distribution and their metabolic significance warrant further investigation.