Masrouri Soroush, Ebrahimi Navid, Soraneh Soroush, Azizi Fereidoun, Hadaegh Farzad
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Int J Obes (Lond). 2025 Sep 8. doi: 10.1038/s41366-025-01858-7.
Relative fat mass (RFM) is strongly associated with type 2 diabetes (T2DM) and has been shown to be a better predictor than body mass index (BMI) and waist circumference (WC). This study aims to investigate the association between RFM and incident T2DM among adults in the Tehran Lipid and Glucose Study cohort.
Data from 8419 participants (4716 women; mean age, 40.52 years) were analyzed. Logistic regression was used to assess the association of RFM with insulin resistance, metabolic syndrome, and its components at baseline. Cox proportional hazards models were applied to evaluate the association between RFM and incident T2DM. Wald tests were used to compare RFM hazard ratios (HRs) with those of BMI, WC, and waist-to-hip ratio (WHR) in the Cox model.
Over a median follow-up of 14 years, 1382 individuals (16.42%) developed T2DM. RFM was significantly associated with insulin resistance, metabolic syndrome, and its components at baseline in both men and women. In the multivariable-adjusted model, each standard deviation increase in RFM was associated with a 1.26-fold (1.02-1.57, P = 0.037) higher risk of T2DM in men and a 1.52-fold (1.27-1.81, P < 0.001) higher risk in women. These associations were stronger in younger individuals and remained significant only in women after adjusting for insulin resistance and restricting the analysis to normoglycemic individuals. The increased T2DM risk associated with RFM was comparable to that associated with WC in both men and women (P > 0.05).
While RFM is strongly associated with the risk of T2DM, particularly in women and younger individuals, it does not outperform WC.
相对脂肪量（RFM）与2型糖尿病（T2DM）密切相关，并且已被证明是比体重指数（BMI）和腰围（WC）更好的预测指标。本研究旨在调查德黑兰血脂与血糖研究队列中成年人的RFM与新发T2DM之间的关联。
对8419名参与者（4716名女性；平均年龄40.52岁）的数据进行分析。采用逻辑回归评估基线时RFM与胰岛素抵抗、代谢综合征及其组分之间的关联。应用Cox比例风险模型评估RFM与新发T2DM之间的关联。在Cox模型中，使用Wald检验比较RFM风险比（HRs）与BMI、WC和腰臀比（WHR）的风险比。
在中位随访14年期间，1382人（16.42%）发生了T2DM。RFM在基线时与男性和女性的胰岛素抵抗、代谢综合征及其组分均显著相关。在多变量调整模型中，RFM每增加一个标准差，男性患T2DM的风险高1.26倍（1.02 - 1.57，P = 0.037），女性高1.52倍（1.27 - 1.81，P < 0.001）。这些关联在较年轻个体中更强，在调整胰岛素抵抗并将分析限制于血糖正常个体后，仅在女性中仍具有显著性。RFM增加的T2DM风险在男性和女性中与WC增加的风险相当（P > 0.05）。
虽然RFM与T2DM风险密切相关，尤其是在女性和较年轻个体中，但它并不优于WC。
