Purpose Obesity has become a public health challenge worldwide and can lead to the development of diabetes. However, studies examining the associations between different obesity patterns and the development of type 2 diabetes mellitus (T2DM) in China are limited. Therefore, this study aimed to explore the associations between three obesity patterns and the risk of T2DM development in Eastern China. Methods A cross-sectional study was conducted at our health examination center, involving 5860 adults, from June to December 2019. Data, including sociodemographic information, lifestyle, and biochemical measurements, were collected, and obesity was classified into three patterns: overweight and general obesity, abdominal obesity, and compound obesity. Multivariate logistic regression was used to assess the associations between different obesity patterns and T2DM risk after adjustment for confounding factors. Subgroup analysis was used to further explore the associations between obesity patterns and T2DM risk. Results A total of 5860 subjects were enrolled in this study. A significant difference in the T2DM incidence was observed between men and women with normal weight or overweight and general obesity ( p < 0.05); however, no significant differences were observed between men and women with abdominal obesity and compound obesity. After multivariable adjustment, multivariate logistic regression analysis showed that the odds ratios (ORs) [95% confidence interval (CI)] for T2DM in individuals with abdominal and compound obesity were 1.55 [1.08–2.24] and 1.85 [1.25–2.73], respectively, compared with the normal-weight group. Subgroup analysis showed that different obesity patterns were not independent risk factors for T2DM development among adults aged ≥ 60 years, whereas abdominal and compound obesity were highly associated with the risk of T2DM development among individuals who report current smoking or alcohol drinking. Conclusion Abdominal obesity and compound obesity are risk factors for T2DM. More attention should be paid to obesity prevention among individuals younger than 60 years and improving control of cigarette and alcohol abuse.

Background: Previous studies have reported the diagnostic values of multiple obesity indicators for predicting the risk of nonalcoholic fatty liver disease. However, the diagnostic values of obesity indicators for predicting the risk of metabolic dysfunctionassociated fatty liver disease (MAFLD) in early postmenopausal women is still unknown. Therefore, this study investigated the predictive values of common obesity indices for estimating the risk of MAFLD in early postmenopausal Chinese women. Methods: This study enrolled 2514 early postmenopausal women, aged between 45 and 55 years, who underwent abdominal ultrasonography examination at the Health examination center of the Huadong Sanatorium between June 2021 and December 2021. The values for six obesity indices, namely, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-toheight ratio (WHtR), body adiposity index (BAI), and Chinese visceral adiposity index (CVAI) were extracted from the medical records. Results: Our data showed that all the six obesity indices were significantly associated with the risk of MAFLD (P < 0.05) in the obese subjects and five obesity indices except for BAI were significantly associated with the risk of MAFLD (P < 0.05) in the lean subjects. The six obesity indices showed a linear relationship with the risk of MAFLD (all P-values > 0.05). The ORs for the obesity indices with the exception of BAI showed proportional increase with the risk of MAFLD in the lean subjects. CVAI was the strongest predictor of the risk of MAFLD in both lean (AUC=0.868) and overweight/obese subjects (AUC=0.704) among the early postmenopausal women. Conclusion:This study demonstrated that all the obesity indices were associated with an increased risk of MAFLD in the obese subjects and five obesity indices except for BAI were associated with an increased risk of MAFLD in the lean subjects among the early postmenopausal women. CVAI showed the strongest predictive performance in estimating the risk of MAFLD among early menopausal women.

Background: Hashimoto's thyroiditis (HT) is recognized as the most common autoimmune thyroid disease, often accompanied by the diffuse enlargement of thyroid with abundant blood flow and elevated level of thyroid autoantibodies. As obesity had a positive association with the risk of HT. Thus, this retrospective study was established to further explore the gender relationship between metabolic obesity phenotypes and the risk of Hashimoto's thyroiditis (HT). Materials and Methods: Data for 3697 subjects aged ≥18 years were randomly collected from a Health check-up database from April to December 2019. Obesity was defined by general obesity (GO; body mass index [BMI] ≥28 kg/m 2 ) and abdominal obesity (AO; waist circumstance, male ≥90 cm, female ≥85 cm). Metabolic unhealthy was defined as having at least one metabolic syndrome component and a homeostasis model assessment of insulin resistance ≥2.5. Obesity phenotypes were divided into three groups: GO, AO, compound obesity (GO+AO). After adjustment for potential confounding factors, multivariate logistic regression was used to assess the association between metabolic obesity phenotypes and risk of HT by sex and explore the correlation between different obesity patterns and HT risk by metabolic health status. Results: The incidence of HT was 23.5% and significantly higher among females than males with different metabolic phenotypes (26.2% vs 20.5%, p<0.05), except metabolically healthy AO. Compared with non-obese subjects, different metabolic obesity phenotypes were independent risk factors among males (p<0.05). Among females, unhealthy metabolic status with GO (adjusted odds ratio [OR]=2.62) or AO (adjusted OR=2.87) and metabolically healthy non-GO (adjusted OR=2.05) were risk factors of HT (p<0.05). Increasing BMI categories and waist circumstance quartiles were positively correlated with HT risk (p for trend <0.05). Subgroup analyses indicated that GO+AO (adjusted OR=2.52) or only AO (adjusted OR=2.41) were risk factors for HT for those with unhealthy metabolic status. Moreover, GO+AO (adjusted OR=2.37) was an independent risk factor for HT under healthy metabolic status. Conclusion: GO+AO was associated with an increased risk of HT, identifying higher BMI/WC as a significant risk factor for HT. Males with unhealthy metabolic state or obesity and metabolically unhealthy females with obesity are high-risk group for HT. Additionally, only AO and GO+AO conferred increased risk of HT for individuals with metabolic abnormalities.

Background and aimsAlthough the association between low muscle mass and the risk of non-alcoholic fatty liver disease is well-known, it has not been explored in viscerally obese populations by gender. Besides, whether low muscle mass still increases the NAFLD risk in subjects with visceral obesity, independent of obesity, is still unknown. The aim of this study was to explore the gender-specific association between low muscle mass and the risk of non-alcoholic fatty liver disease (NAFLD) in subjects with visceral obesity.MethodsOverall, 1,114 participants aged 19–89 years were recruited in this retrospective study. Liver disease was diagnosed by hepatic ultrasound. Skeletal muscle mass was estimated by bioimpedance analysis and defined by the appendicular skeletal muscle index (ASMI). Gender-specific differences in the ASMI value were compared between NAFLD and control groups. Restricted cubic spline and multivariate logistic regression were performed to analyze the association (stratified by gender and age) between the ASMI and the risk of NAFLD, respectively.ResultsMiddle-aged females (40–60 years) and males (of any age) with NAFLD had a significantly lower ASMI compared with controls (P-value &lt; 0.05). An inverse linear association was found between the ASMI and risk of NAFLD (all Pfornon−linearity &gt; 0.05). Lower quartiles of the ASMI conferred independent risk of NAFLD compared to higher quartiles (all P for trend &lt; 0.001). Low muscle mass conferred a higher risk of NAFLD in middle-aged females (adjusted odds ratio = 2.43, 95% confidence interval: 1.19–4.95) and males [18–39 years: 3.76 (1.79–7.91); 40–60 years: 4.50 (2.16–9.39); and &gt;60 years: 4.10 (1.13–14.84)]. Besides, Low muscle mass and low muscle mass with obesity increase the risk of developing NAFLD, independent of obesity.ConclusionAmong those with visceral obesity, low muscle mass increased the risk of NAFLD in males of any age, and middle-aged females, this may be explained by the postmenopausal decline in estrogen.

Background This study aimed to evaluate whether the low appendicular skeletal muscle index (ASMI) is closely associated with the risk of carotid artery plaque (CAP) in postmenopausal women with and without hypertension/hyperglycemia stratified by body mass index (BMI) categories. Methods A total of 2048 Chinese postmenopausal women aged 40–88 years were eventually enrolled in this retrospective study. Skeletal muscle mass was estimated by using segmental multifrequency bioelectrical impedance analysis. ASMI was defined as follows: appendicular skeletal muscle mass(kg)/[height(m)]2. CAP was assessed by B-mode ultrasound. We explored the association between ASMI quartiles or low skeletal muscle mass and the risk of CAP by using multivariate-adjusted logistic regression models. A potential nonlinear relationship was also tested using restricted cubic spline regression. Results CAP was observed in 289/1074 (26.9%) normal-weight and 319/974 (32.8%) overweight/obese postmenopausal women. Individuals with CAP had significantly lower ASMI values than those without (P < 0.001). The ASMI value also showed a linear relationship with the CAP risk in postmenopausal women stratified by BMI category (Pfor non−linearity > 0.05). In comparison with the highest ASMI quartile, the lowest ASMI quartile was significantly associated with a high risk of CAP development in non-hypertensive individuals with normal weight (odds ratio [OR] = 2.43; 95% confidence interval [CI]: 1.44 ~ 4.12) or overweight/obesity (OR = 4.82, 95% CI: 2.79 ~ 8.33), hypertensive individuals with normal weight (OR = 5.90, 95% CI: 1.46 ~ 11.49) or overweight/obesity (OR = 7.63, 95% CI: 1.62 ~ 35.86), non-hyperglycemic individuals with normal weight (OR = 2.61, 95% CI: 1.54 ~ 4.43) or overweight/obesity (OR = 2.94, 95% CI: 1.84 ~ 4.70), and hyperglycemic individuals with normal weight (OR = 6.66, 95% CI: 1.08 ~ 41.10) or overweight/obesity (OR = 8.11, 95% CI: 2.69 ~ 24.49). Moreover, low skeletal muscle was independently associated with the risk of CAP in postmenopausal women, regardless of the BMI category. Conclusion ASMI was inversely associated with the risk of CAP development in postmenopausal women, especially in patients with high blood sugar and/or hypertension, indicating that skeletal muscle mass maintenance may contribute to prevention of CAP in postmenopausal women.