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. 2017 Apr 18;1(6):600-608.
doi: 10.1210/js.2017-00046. eCollection 2017 Jun 1.

The Association of Percent Body Fat and Lean Mass With HbA1c in US Adults

Julie K Bower  1   2 , Rachel J Meadows  1 , Meredith C Foster  3 , Randi E Foraker  1   2 , Abigail B Shoben  1
Affiliations

The Association of Percent Body Fat and Lean Mass With HbA1c in US Adults

Julie K Bower et al. J Endocr Soc. .

Abstract

Context: Body fat and body composition distribution patterns affect diabetes risk and glycemic control, but most studies use proxy measures (e.g., body mass index).

Objective: This study examined the association of percent body fat and lean mass with glycated hemoglobin (HbA1c) in US adults.

Design: The National Health and Nutrition Examination Survey (NHANES) is a program of cross-sectional studies that enroll nationally representative samples of the US civilian noninstitutionalized population.

Setting: NHANES is designed to assess the health status of adults and children throughout the United States.

Participants: This study included 11,125 participants aged 18 to 69 years from the 1999 through 2006 NHANES, comprising 846 persons with diagnosed diabetes and 10,125 without diabetes.

Main outcome measures: Total and abdominal (trunk) percent body fat and lean mass were measured using dual-energy x-ray absorptiometry. Linear and logistic regression analyses were used to examine their association with HbA1c.

Results: Among those without diagnosed diabetes, total and trunk percent body fat, as well as trunk and total lean mass, were strongly associated with elevated HbA1c; odds ratios per 5% increment for the association of percent body fat with HbA1c >5.7% (39 mmol/mol) ranged from 1.60 to 2.01 across age and sex categories. Among adults with diabetes, higher total percent fat was associated with higher HbA1c in males age <40 years and higher trunk fat was associated with higher HbA1c in females across age categories.

Conclusions: Lifestyle interventions to lower HbA1c should consider targeting both weight loss and body composition.

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