This cross-sectional study investigates the dose-response associations between body fat and glycemic profiles captured through continuous glucose monitoring (CGM) in Asian adults without diabetes. Conducted by a team from the Saw Swee Hock School of Public Health and other institutions, the research aims to fill a gap in large-scale studies examining these relationships.
Background
Understanding how body fat impacts glycemic control is crucial for developing effective metabolic health strategies. Previous research has often overlooked the nuances of how different types of body fat influence blood glucose levels and variability. This study specifically targets an Asian cohort, providing insights that may differ from findings in other populations.
Methods
The study included 882 participants, with a mean age of 40.2 years and a majority being female (63%). Participants underwent dual-energy X-ray absorptiometry (DXA) scans to assess body composition and wore CGM devices for nine days to monitor their glycemic levels. The primary metrics analyzed were mean blood glucose (MBG) and the coefficient of variation (CV) to evaluate glycemic variability.
Results
Results indicated that whole-body and regional body fat measures had predominantly linear and positive associations with MBG. Notably, visceral fat percentage exhibited the strongest positive correlation with CGM-derived MBG, with a reported increase of 3.76 mg/dl per standard deviation of fat. Conversely, leg fat percentage showed a negative association with MBG, suggesting that higher leg fat may contribute to lower glucose levels.
In terms of glycemic variability, U-shaped nonlinear associations were observed for most body fat measures. For instance, visceral fat mass was inversely associated with CV at lower fat levels but positively associated at higher fat levels, indicating that both extremes of body fat can lead to increased glycemic variability.
Conclusions
The findings underscore the complexity of the relationship between body fat and glucose control. Higher total and central fat mass, particularly visceral fat, correlates with elevated glucose levels, while a greater proportion of leg fat is linked to lower glucose levels. Moreover, glycemic variability appears to be influenced by both the amount and distribution of body fat.
These results suggest that metabolic health strategies should consider the dynamics of glycemic levels and variability, along with the distribution of body fat, to better address blood glucose control in individuals.
What this study does not show
This study does not establish causation between body fat and glycemic levels or variability, nor does it provide insights into the long-term health outcomes related to these associations.
Evidence scorecard
- Analytic validity: Established
- Clinical validity: Not established
- Clinical utility: Not established
The evidence is based on primary research involving human participants.