Sex Differences in the Associations Between Visceral Adiposity and Hepatic Insulin Clearance in Type 2 Diabetes Mellitus: A Quantitative Computed Tomography (CT) Study
Authors' conclusion
The association between visceral adiposity and HIC is sex-related, with preserved adaptation in women but not in men. Visceral adiposity is more strongly associated with clearance dynamics than static hepatic steatosis, improving the pathophysiological characterization of T2DM.
Study context
- Population
- Inpatients with T2D; regional and ectopic fat quantified by deep-learning CT; Hepatic insulin clearance (HIC) derived from OGTT
- Participants
- 234 inpatients
- Exposure
- Women vs men
- Womenn = 88
- Menn = 146
- Outcome
- Association of body fat distribution (VAT, hepatic fat) with hepatic insulin clearance (HIC), by sex
Methodological detailspropensity score matching, multivariable regression
- Propensity score matching
- Multivariable regression
Main finding
As reported in the abstract
Association of VAT with HIC, adjusted for insulin resistance
| Group | β | P |
|---|---|---|
| Women | 0.395 | P = 0.008 |
| Men | −0.047 | P = 0.636 |
β
Women0.395
Men−0.047
P
WomenP = 0.008
MenP = 0.636
- Women vs Men: P for interaction = 0.025 — propensity score matching (PSM) cohort
- Women vs Men: P for interaction = 0.07 — PSM cohort, additional adjustment for insulin resistance
Observational data: associations, not effects.
Further findings
Fat distribution by sex
- Men had larger visceral adipose tissue (VAT) areas; women had higher hepatic fat
VAT and systemic insulin resistance
- VAT was independently associated with systemic insulin resistance
CT-assessed hepatic fat and HIC
- CT-assessed hepatic fat showed no independent association with HIC
Original publication
Sex Differences in the Associations Between Visceral Adiposity and Hepatic Insulin Clearance in Type 2 Diabetes Mellitus: A Quantitative CT Study. Diabetes Res Clin Pract. Published 22 March 2026. doi:10.
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