Ectopic fat distribution and its correlation with insulin resistance indices in non-obese individuals with type 2 diabetes.

BACKGROUND

This study examined the links between regional adiposity and insulin resistance in non-obese adults with type 2 diabetes.

METHODS

This post-hoc analysis utilized data from a randomized controlled trial involving participants with type 2 diabetes who were recruited from a hospital in East China between December 2018 and January 2019. Pancreatic fat content (PFC), liver fat content (LFC), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were quantified using the IDEAL-IQ water–fat separation technique. Insulin resistance was assessed using homeostasis model assessment of insulin resistance (HOMA2-IR), Matsuda index, Raynaud’s insulin sensitivity index, triglyceride-glucose (TyG) index, and estimated glucose disposal rate (eGDR). Associations were examined using univariate and multivariate linear regression analyses.

RESULTS

Data from 84 participants were analyzed. After adjusting for age, gender, duration of diabetes, HbA1c, BMI, and LDL-C, linear regression analysis demonstrated significant correlations between LFC and VAT with HOMA2-IR (β = 0.053, P = 0.011; β = 0.007, P < 0.001 ) and the TyG index (β = 0.034, P = 0.032; β = 0.006, P < 0.001 ). Additionally, VAT and SAT showed correlations with Raynaud’s insulin sensitivity index (β= -0.037, P = 0.018; β= -0.035, P = 0.021 ) and the Matsuda index (β= -0.903, P = 0.027; β= -0.781, P = 0.048 ).

CONCLUSIONS

In non-obese individuals with type 2 diabetes, LFC, VAT, and SAT were significantly associated with insulin resistance, with VAT showing the strongest link. These findings suggest that assessing regional fat distribution can identify insulin resistance in non-obese type 2 diabetes, enabling early risk stratification and targeted intervention.