Pathophysiological significance in abdominal fat distribution in non-obese children with type 2 diabetes

• Published in: Endocrine Journal Vol. 70; no. 4; pp. EJ22-0449 - 452
• Main Authors: Urakami, Tatsuhiko, Kuwabara, Remi, Suzuki, Junichi, Abe, Yuriko, Hara, Mitsuhiko, Morioka, Ichiro
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2023; Japan Science and Technology Agency
• Subjects: Adolescent; Body Mass Index; Child; Children; Computed tomography; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - metabolism; Dyslipidemia; Female; Glucose Intolerance - metabolism; Glucose tolerance; Humans; Intolerance; Intra-Abdominal Fat - diagnostic imaging; Intra-Abdominal Fat - metabolism; Liver diseases; Metabolic disorders; Non-obesity; Subcutaneous Fat; Type 2 diabetes; Visceral fat; Type 2 diabetes; Visceral fat; Subcutaneous fat; Children; Non-obesity
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ22-0449

The aim of the study was to determine the pathogenesis of non-obese children with type 2 diabetes, and its relationship with fat distribution. The study participants included 36 obese children with type 2 diabetes (age: 13.5 years, BMI: 28.3, BMI percentile: 91.9) and 30 non-obese children with type 2 diabetes (age: 13.5 years, BMI: 23.1, BMI percentile: 74.0). The proportion of female participants was significantly higher in non-obese children than in obese children (73.3% vs. 41.7%, p < 0.001). Abdominal fat distribution, evaluated by subcutaneous fat (SF) area, visceral fat (VF) area, and the ratio of VF area to SF area (V/S ratio), measured using computed tomography, and serum lipid levels and liver function were compared between the two groups. Non-obese children with type 2 diabetes had significantly smaller SF area and also smaller VF area than obese children with type 2 diabetes (SF area: 158.3 m2 vs. 295.3 m2, p < 0.001, VF area: 71.0 m2 vs. 94.7 m2, p = 0.032). Whereas non-obese children with type 2 diabetes had significantly greater V/S ratio than obese children with type 2 diabetes (0.41 vs. 0.31, p = 0.007).The prevalence of dyslipidemia and liver dysfunction were similar in the two groups. In conclusion, non-obese children with type 2 diabetes had excess accumulation of VF despite a small amount of SF, which might be associated with glucose intolerance and other metabolic disorders.