Lee Seung-Hee, Heo Seo-Jeong, Park Jonghoon
Department of Physical Education, Korea University, Seoul, Republic of Korea.
Phys Act Nutr. 2025 Jun;29(2):77-83. doi: 10.20463/pan.2025.0017. Epub 2025 Jun 30.
The extracellular-to-intracellular water (ECW/ICW) ratio is a known indicator of metabolic health; however, few studies have examined its association with type 2 diabetes mellitus (T2DM). This study investigated the relationship between the ECW/ICW ratio and T2DM prevalence using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
We analyzed the data of 2,281 Korean males aged 19-80 years who participated in the 9th KNHANES (2022-2023) and had no history of kidney disease. The participants were classified as normal, prediabetic, or diabetic based on their fasting glucose levels, Hemoglobin A1c levels, and physician diagnosis. The ECW/ICW ratio was divided into tertiles. One-way analysis of variance (ANOVA) with Bonferroni post hoc tests was used to compare group differences in general and body composition characteristics. Logistic regression analyses were used to assess the association between ECW/ICW tertiles and T2DM prevalence.
The diabetes group had significantly higher age, body mass index (BMI), waist circumference, and body fat percentage, and lower fat-free mass and grip strength than the other groups (p <.001). They had lower ICW values and higher ECW/total body water (TBW) and ECW/ICW ratios. Compared to the lowest tertile group, the middle tertile group showed a significantly higher risk of diabetes (OR = 1.661, 95% CI, 1.104-2.499), whereas the highest tertile did not reach statistical significance (OR = 1.417, 95% CI: 0.880-2.280) in the model adjusted for age, BMI, and grip strength.
This study identified a significant association between a higher ECW/ICW ratio and the prevalence of T2DM in Korean males, independent of age, BMI, and muscle strength. The ECW/ICW ratio reflects both metabolic and musculoskeletal characteristics and may be useful in describing diabetes-related body composition profiles.
细胞外水与细胞内水比例（ECW/ICW）是已知的代谢健康指标；然而，很少有研究探讨其与2型糖尿病（T2DM）的关联。本研究利用韩国国民健康与营养检查调查（KNHANES）的数据，调查了ECW/ICW比例与T2DM患病率之间的关系。
我们分析了2281名年龄在19 - 80岁、参加第九次KNHANES（2022 - 2023年）且无肾脏疾病史的韩国男性的数据。根据空腹血糖水平、糖化血红蛋白水平和医生诊断，将参与者分为正常、糖尿病前期或糖尿病组。ECW/ICW比例分为三分位数。采用单因素方差分析（ANOVA）及Bonferroni事后检验比较各组在一般特征和身体成分特征方面的差异。采用逻辑回归分析评估ECW/ICW三分位数与T2DM患病率之间的关联。
糖尿病组的年龄、体重指数（BMI）、腰围和体脂百分比显著高于其他组，而无脂肪量和握力低于其他组（p <.001）。他们的ICW值较低，ECW/总体水（TBW）和ECW/ICW比例较高。在调整了年龄、BMI和握力的模型中，与最低三分位数组相比，中间三分位数组患糖尿病的风险显著更高（OR = 1.661，95% CI，1.104 - 2.499），而最高三分位数组未达到统计学显著性（OR = 1.417，95% CI：0.880 - 2.280）。
本研究发现，在韩国男性中，较高的ECW/ICW比例与T2DM患病率之间存在显著关联，且独立于年龄、BMI和肌肉力量。ECW/ICW比例反映了代谢和肌肉骨骼特征，可能有助于描述与糖尿病相关的身体成分概况。
