Relationship between visceral fat and diabetes mellitus in the elderly: A cross-sectional study

Diabetes mellitus and obesity are major public health concerns in older adults, and visceral adipose tissue (VAT) is suggested to play a critical role in the metabolic dysfunction observed in type 2 diabetes. This cross-sectional study investigated the relationship between VAT and other obesity-related indicators with type 2 diabetes mellitus in elderly adults in northern Iran.

Participants aged 60 years and older were included, comprising 300 individuals with diabetes and 600 controls for comparative analysis, matched by age and sex. Demographic characteristics, physical activity, anthropometric measures, fasting blood sugar (FBS), and lipid profile were assessed. VAT and other body fat parameters were measured using dual-energy x-ray absorptiometry (DXA). Statistical analyses including t-tests, Pearson correlation, and ROC curve analysis were performed.

The diabetic group had a significantly higher VAT mass (954.54±319.82 vs. 831.95±323.20, p <0.001) and volume (1031.92±345.79 vs. 899.38±349.43, p <0.001) than controls, while total body fat mass and percentage were not significantly different in between groups (p = 0.052, 0.878; respectively). FBS showed positive correlation with VAT metrics (r = 0.127, p < 0.001). VAT mass and volume yielded the highest AUCs (0.605, 95% CI: 0.567-0.644, p < 0.001) for diabetes discrimination.

Our findings support the significant association of VAT and diabetes in older adults, in contrast to general fat measures. However, discriminatory power of VAT remained poor to inconclusive in our study, especially in older women. Further analysis is needed to clarify the clinical utility of VAT in screening and prevention.