According to Torgny Karlsson, PhD, and colleagues from Uppsala University in Sweden, visceral fat that accumulates around the organs and intestines is a crucial factor that raises the risk of type 2 diabetes. While health advocates have focused on the overall amount of fat, this new research underscores that the type of fat might be the real issue, especially for women.  

Dr. Karlsson added, “To measure the amount of visceral fat, advanced and costly diagnostic imaging techniques are required. We have developed a simple method, which instead estimates an individual's amount of deep belly fat from other parameters more easily measured than the visceral fat itself, and the method can, therefore, be used in most clinics.”

Using a sex-stratified, nonlinear prediction model, the team conducted a genome-wide association study using data on 325,153 individuals in the United Kingdom Biobank. The evaluation was conducted to identify genetic variants that influence visceral adipose tissue (VAT) distribution. Study analysis demonstrated that visceral fat, adjusted for BMI, is a causal risk factor associated with increased risk of hypertension, angina, type 2 diabetes, and hyperlipidemia. 

“We were surprised that visceral fat was more strongly linked to risk of disease in women compared to men,” said Åsa Johansson, a coauthor of the study and an associate professor at Uppsala University. “Adding an extra kilogram of visceral fat can increase the risk of type 2 diabetes more than seven times in women, while the same amount of fat accumulation only increases the risk a little more than two times in men,” Dr. Johansson added. The importance of understanding the additional harmful risks of VAT that are not captured by BMI is essential in recognizing VAT’s harm when compared with other fat deposits, such as subcutaneous fat stores.

The authors concluded that visceral adiposity either is more proinflammatory (promoting insulin resistance) or is more lipolytic and resistant to antilipolytic effects of insulin, resulting in higher levels of circulating free fatty acids. The largest difference in causal effect between the sexes was found for type 2 diabetes in females (OR 7.34; 95% CI, 4.48-12.0) compared with males (OR 2.50; 95% CI, 1.98-3.14). Although the study found that Caucasian females have the most significant risk, the research team underscored the importance of conducting more research to validate these findings and  explore whether the results are consistent in other ethnic groups and populations outside the UK and to “gain a deeper understanding of the biology behind the complex relationship between VAT mass and disease.” 

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