Background: India is the world’s capital of ‘thin-fat’ phenotype and young onset diabetes. Abdominal adiposity is a possible explanation. We studied the association of abdominal fat distribution by MRI with glucose-insulin metabolism.

Methods: Young adults [18 years, n=595 (308 boys), PMNS cohort] were classified by ADA 75 g OGTT as NGT and prediabetic. We measured anthropometry, total body fat (DXA), and glucose-insulin parameters (HOMA, Insulinogenic and Matsuda index), and visceral (VAT) and subcutaneous (SAT) abdominal adiposity by MRI.

Results: Prediabetic boys were shorter, had a higher BMI, WHR, VAT and SAT compared to NGT boys. Conversely, prediabetic girls had similar BMI, VAT and SAT. SAT was twice as strongly associated than VAT with glucose, insulin resistance, triglycerides and cholesterol concentrations. On multiple regression SAT remained strongly and independently associated.

Conclusion: Unlike in Europeans, SAT has a stronger ‘detrimental’ association with cardio-metabolic risk factors compared to VAT. This may indicate a different adipose biology in Indians and needs further investigation.

R.H. Wagh: None. R.U. Bawdekar: None. W. Alenaini: None. E.L. Thomas: None. J.D. Bell: None. C.S. Yajnik: None.

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