Sex-specific protective role of lower-body fat in type 2 diabetes: mediation through insulin resistance in a body mass index (BMI)-matched population
Authors' conclusion
This study delineates a protective role for lower-body fat in diabetes pathogenesis, mediated substantially through ameliorating insulin resistance. The sex-specific associations underscore the protective effect of lower-body fat and the detrimental impact of visceral adiposity in men after controlling for BMI.
Study context
- Population
- BMI-matched National Health and Nutrition Examination Survey (NHANES) participants, 2011–2018 cyclesBMI-matched
- Exposure
- High T2D risk vs healthy controls
- Outcome
- Regional body composition and T2D risk
Methodological detailsBMI-matched, NHANES 2011-2018, DXA body composition, mediation analysis
- BMI-matched
- NHANES 2011-2018
- DXA body composition
- Mediation analysis
Main finding
As reported in the abstract
Share of protective effect of lower limb fat on diabetes mediated by improved insulin sensitivity
36.18%
Observational data: associations, not effects.
Further findings
Lower-limb fat and T2D risk, males
- OR (0.76-0.97), p=0.01
- 0.86
- Particularly pronounced in male subjects
Visceral fat and T2D risk, males
- OR (1.57-34.4), p=0.01
- 7.35
- Particularly pronounced in male subjects
Original publication
Sex-specific protective role of lower-body fat in type 2 diabetes: mediation through insulin resistance in a BMI-matched population. BMJ Open Diabetes Res Care. Published 4 November 2025. doi:10.
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