Metabolic Characteristics of Adults With Diabetes and Preserved Body Mass Index
DOI:
https://doi.org/10.61336/jdme.0501.02Keywords:
Type 2 diabetes mellitus, normal BMI, metabolic health, central adiposity, body compositionAbstract
Adults with diabetes who maintain a body mass index within the non-obese range may nevertheless exhibit substantial metabolic abnormalities. This study characterized the metabolic profile of adults with diabetes and preserved body mass index and examined the relationship between body composition, central adiposity, insulin resistance, glycemic status, lipid metabolism, and inflammatory markers. A cross-sectional clinical study was conducted among 192 adults with type 2 diabetes and BMI below 30 kg/m². Anthropometric measurements, fasting biochemical parameters, body composition assessment, glycemic indices, lipid profile, liver enzymes, inflammatory biomarkers, and renal parameters were evaluated. Insulin resistance was estimated using HOMA-IR, while body composition was assessed using bioelectrical impedance analysis. Despite preserved BMI, 42.7% of participants demonstrated increased waist-to-height ratio, 38.5% had elevated body-fat percentage, and 46.9% showed evidence of insulin resistance. Participants with greater central adiposity had higher fasting insulin, HOMA-IR, triglycerides, HbA1c, ALT, uric acid, and hs-CRP concentrations and lower HDL cholesterol. A metabolically adverse phenotype was also observed among participants with relatively normal BMI but increased visceral fat estimates. After adjustment for age, sex, diabetes duration, physical activity, and BMI, waist-to-height ratio and body-fat percentage remained independently associated with insulin resistance. These findings indicate that preserved BMI does not necessarily reflect favorable metabolic health in adults with diabetes and that assessment of body-fat distribution and metabolic biomarkers may provide additional information for identifying individuals at increased metabolic risk.
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