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Original Articles
- Metabolic Risk/Epidemiology
- Association of Body Composition Changes with the Development of Diabetes Mellitus: A Nation-Wide Population Study
- Hyung Jun Kim, Hyung-Woo Lee, Min-Kyoung Kang, Gwang Hyun Leem, Min-Ho Kim, Tae-Jin Song
- Diabetes Metab J. 2024;48(6):1093-1104. Published online May 21, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0243
- 10,476 View
- 243 Download
- 7 Web of Science
- 10 Crossref
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
We investigated the association between body composition changes and new-onset diabetes mellitus (DM) development according to the body mass index (BMI) in a longitudinal setting in the general Korean population.
Methods
From 2010 to 2011 (1st) and 2012 to 2013 (2nd), we included 1,607,508 stratified random sample participants without DM from the National Health Insurance Service-Health Screening dataset of Korean. The predicted appendicular skeletal muscle mass index (pASMMI), body fat mass index (pBFMI), and lean body mass index (pLBMI) were calculated using pre-validated anthropometric prediction equations. A prediction equation was constructed by combining age, weight, height, waist circumference, serum creatinine levels, alcohol consumption status, physical activity, and smoking history as variables affecting body composition.
Results
Decreased pASMMI (men: hazard ratio [HR], 0.866; 95% confidence interval [CI], 0.830 to 0.903; P<0.001; women: HR, 0.748; 95% CI, 0.635 to 0.881; P<0.001), decreased pLBMI (men: HR, 0.931; 95% CI, 0.912 to 0.952; P<0.001; women: HR, 0.906; 95% CI, 0.856 to 0.959; P=0.007), and increased pBFMI (men: HR, 1.073; 95% CI, 1.050 to 1.096; P<0.001; women: HR, 1.114; 95% CI, 1.047 to 1.186; P=0.007) correlated with the development of new-onset DM. Notably, only in the overweight and obese BMI categories, decreases in pASMMI and pLBMI and increases in pBFMI associated with new-onset DM, regardless of gender.
Conclusion
Decreased pASMMI and pLBMI, and increased pBFMI with excess fat accumulation may enhance the risk of newonset DM. Therefore, appropriate changes in body composition can help prevent new-onset DM. -
Citations
Citations to this article as recorded by
- Impact of Long-Term Insulin Therapy on Body Composition and Metabolic Age in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study Using Bioelectrical Impedance Analysis
Cut Husna, Darmawati ., Sarah Firdausa, Irfanita Nurhidayah, Ahyana .
The Open Nursing Journal.2026;[Epub] CrossRef - Associations of Body Composition and Physical Function With Incident Diabetes in Older Adults: A 14‐Year Prospective Cohort Study
Ting Zhang, Shuyi Li, Yafei Wu, Jason Leung, Alice Pik‐Shan Kong, Amany K. Elshorbagy, T. W. Auyeung, Timothy Kwok
Journal of Cachexia, Sarcopenia and Muscle.2026;[Epub] CrossRef - Association Between Body Composition and Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Xinrui Cao, Guoli Shen, Ting Sun
Diabetes, Metabolic Syndrome and Obesity.2026; Volume 19: 1. CrossRef - Reciprocal risks of diabetes and sarcopenia in aging Chinese adults: A prospective cohort study using a semi-Markov multi-state framework
Yirui Chen, Yinuo Qu, Siyi Kong, Tianyun Wang, Zhiyuan Liu, Huixia Ren, Kai Ma, Tieniu Zhao, Hongwu Wang, Mengyang Wang
Medicine.2026; 105(26): e49398. CrossRef - Differences in Body Composition in Patients with Pheochromocytomas and Age- and Sex-Matched Non-Functioning Adrenal Tumors: A Matched Cohort Study
Yiraldine Herrera-Martínez, Miguel Ángel Gómez-Bermejo, Marta Araujo-Castro, César Minguez-Ojeda, Maria Angeles Galvez-Moreno, María José Molina Puerta, Aura D. Herrera-Martínez
Endocrine Practice.2026;[Epub] CrossRef - Integrated Fat-Muscle Patterns Drive Sex-Specific Diabetes Risk: UK Biobank Evidence
Yifan Ma, Ning Zhou, Boya Yu, Zixiao Liang, Mengjie Xiao, Guoqiang Jing, Xu Zhang, Xin Liu, Changhao Sun, Huanyu Wu
Diabetes.2026; 75(9): 1596. CrossRef - Effects of diabetes complications on body composition, dietary intake, and metabolic parameters
Tuba Tekin, Başak İkra Yıldız, Şaziye Yoldaş, Mustafa Asım Gedikli
Acta Diabetologica.2026;[Epub] CrossRef - Daily Mango Intake Improves Glycemic and Body Composition Outcomes in Adults with Prediabetes: A Randomized Controlled Study
Raedeh Basiri, Kallie Dawkins, Saiful Singar, Lauren T. Ormsbee, Neda S. Akhavan, Robert C. Hickner, Bahram H. Arjmandi
Foods.2025; 14(17): 2971. CrossRef - Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort
Hyun-Jin Kim, Byung Sik Kim, Hasung Kim, Jungkuk Lee, Ha Hye Jo, Dong Wook Kim, Jeong-Hun Shin, Ki-Chul Sung
The Korean Journal of Internal Medicine.2025; 40(6): 975. CrossRef - Inhibition of CILP2 Improves Glucose Metabolism and Mitochondrial Dysfunction in Sarcopenia via the Wnt Signalling Pathway
Zhibo Deng, Chao Song, Long Chen, Rongsheng Zhang, Linhai Yang, Peng Zhang, Yu Xiu, Yibin Su, Fenqi Luo, Jun Luo, Hanhao Dai, Jie Xu
Journal of Cachexia, Sarcopenia and Muscle.2024; 15(6): 2544. CrossRef
- Impact of Long-Term Insulin Therapy on Body Composition and Metabolic Age in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study Using Bioelectrical Impedance Analysis
- The Appropriteness of New ADA Diagnostin Criteria for Diabetes Mellitus in Korean Population.
- Moon kyu Lee, Myung Shik Lee, Young Ki Min, Sung Hoon Kim, Byoung Joon Kim, Dong Jun Kim, Jong Ryeal Hahm, Eun Young Oh, Yun Jae Chung, Kyoung Ah Kim, Jae Hoon Chung, Kwang Won Kim
- Korean Diabetes J. 1999;23(3):336-351. Published online January 1, 2001
- 2,499 View
- 18 Download
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Abstract
PDF
- BACKGROUND
The ADA has proposed a new diagnostic criteria for diabetes based on fasting plasma glucose, redefining diabetes as fasting plasma glucose 7.0 mmol/L. Since only a few studies for the appropriateness of tbis new ADA criteria were undertaken in the Korean population, we examined the appropriateness of the new ADA criteria by analyzing the results of oral glucose tolerance tests done in our hospital. METHODS: 507 oral glucose tolerance tests were conducted. Cases with diabetes and diseases that could affect the glucose tolerance were excluded. Plasma glucose was measured by the hexokinase method. Three groups of NGT, IGT, and DM by the WHO criteria of 2 hour-plasma glucose were redivided at each level of fasting plasma glucose. We calculated the sensitivity and specificity of each level of fasting plasma glucose (FPG), and the FPG value of maximum accuracy to diagnose diabetes with reference to the WHO criteria of 2 hour-plasma glucose. RESULTS: Correlation between the levels of fasting plasma glucose and 2 hour-plasma glucose was relatively low (r=0.676). FPG of 7.0 mmol/L for diagnosing diabetes was relatively specific (specificity=0.934), but not sensitive (sensitivity= 0.552). FPG value of maximum accuracy for diagnosing diabetes was 6.8 mmol/L. 39 % of IFG (> 6.1mmol/L and < 7.0mmol/L) was reclassified as diabetes by the criteria of 2 hour plasma glucose 11.1 mmol/L and 34 % of NFG (<6.1mmol/L) was reclassified as impaired glucose tolerance by the criteria of 2 hour plasma glucose > 7.8 mmol/L. CONCLUSION: The fasting plasma glucose of 7.0 mmol/L was relatively specific for diagnosing diabetes. However, the new ADA criteria tended to underestimate the prevalence of diabetes and impaired glucose tolerance in the Korean population. Therefore, oral glucose tolerance test may be needed to diagnose diabetes in high risk subjects. Large-scale cross-sectional and prospective studies will be needed to clarify these points.
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