China: Arm fat and trunk fat are positively associated with the risk of cardiovascular disease (CVD) and mortality among people with type 2 diabetes (T2D), a recent study has revealed. However, leg fat was shown to be inversely associated with the risk of CVD and mortality.
The findings, published in The Journal of Clinical Endocrinology & Metabolism highlight the importance of considering body fat amount and location for CVD and mortality risk assessment among individuals with T2D.

The intricate relationship between body fat distribution and health outcomes has been the subject of considerable research, particularly in individuals with type 2 diabetes. Recent studies have delved into the associations of regional body fat with the risk of CVD and mortality in this population, shedding light on crucial aspects of diabetes management and prevention strategies.
One of the focal points of investigation has been adipose tissue distribution, particularly visceral fat versus subcutaneous fat. Visceral fat, located around internal organs, has been implicated in metabolic disturbances, insulin resistance, and a higher risk of CVD events. Subcutaneous fat, found beneath the skin, has traditionally been considered less harmful. However, emerging evidence suggests that its distribution and characteristics also play a significant role in cardiometabolic health.
Against the above background, Gang Liu, Huazhong University of Science and Technology, Wuhan, China, and colleagues aimed to prospectively examine the association between regional body fat and CVD risk in individuals with type 2 diabetes, who often exhibit changes in relative fat distribution and have increased CVD risk.
The main analysis comprised 21,472 participants with T2D from the UK Biobank. Regional body fat was measured by bioelectric impedance assessment. Cox proportional hazard regression models were used to estimate hazard ratios (HRs).
The study led to the following findings:
Over a median of 7.7 years of follow-up, 3,976 CVD events occurred.
After multivariable adjustment, upper and lower body fat were independently and oppositely associated with CVD risk among patients with T2D.
Higher arm fat percentage was linearly associated with increased CVD risk, while higher trunk fat percentage was nonlinearly associated with increased CVD risk.
Higher leg fat percentage was nonlinearly associated with lower CVD risk.
When comparing extreme quartiles, the multivariable-adjusted HR of CVD was 0.72 for leg fat percentage, 1.63 for arm fat percentage, and 1.27 for trunk fat percentage.
Similar patterns of associations were observed for all-cause and CVD mortality.
Leg fat percentage, but not other regional fat percentage, was associated with CVD risk independently of traditional measures of obesity.
In conclusion, higher levels of arm and trunk fat were linked to greater CVD and mortality risks for people with T2D. In contrast, higher levels of leg fat were associated with reduced CV and mortality risks.
Reference:
Qiu, Z., Lee, D. H., Lu, Q., Li, R., Zhu, K., Li, L., Li, R., Pan, A., Giovannucci, E. L., & Liu, G. Associations of Regional Body Fat with Risk of Cardiovascular Disease and Mortality among Individuals with Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgae192