LAUSR

PURPOSE Visceral adipose tissue (VAT) may be more important than subcutaneous fat in type 2 diabetes (T2D) etiology. We examined a VAT score developed in reference to MRI measurement of VAT in the Multiethnic Cohort (MEC) as a risk factor for incident T2D. METHODS Two nested case-control studies of cancer allowed calculation of the VAT score based on anthropometric measures and eight biomarkers among 2,556 participants without T2D. Incident cases were identified from Medicare linkages and self-reports after blood draws in 2001-2006. Cox regression with age as time metric was applied to estimate the association of the VAT score with T2D. RESULTS During 10.1±2.4 years, 355 incident T2D cases were identified. VAT scores were higher in T2D cases than among those without disease (5.06±0.43 vs. 4.95±0.41; p<0.0001) and significantly associated with T2D (HR=2.70; 95%CI 1.60, 4.58 per unit) with similar values in men (HR=2.99; 95%CI 1.03, 8.73) and women (HR=2.61; 95%CI 1.39, 4.91). A significant association was observed in all five ethnic groups but only statistically significant among Japanese Americans (HR=6.24; 95%CI 2.34, 16.68). CONCLUSIONS These findings support that VAT as estimated by a biomarker-based score predicts T2D incidence beyond BMI in particular among older adults of Japanese ancestry.