1142-P: Fat Distribution in Youth-Onset Type 2 Diabetes

Adult studies show that females generally have higher total body fat than males, with higher subcutaneous adipose tissue (SAT), yet less visceral adipose tissue (VAT), an independent risk factor for cardiovascular disease. Less is known about fat distribution in youth-onset type 2 diabetes (Y-T2D) and severe obesity (SO), specifically SAT, VAT, or the VAT/SAT ratio. Here we examine fat-specific depots by sex in participants with SO and Y-T2D enrolled in ST₂OMP, a study comparing metabolic bariatric surgery (MBS) to medical treatment for Y-T2D. Abdominal MRI was performed at enrollment and volumetric analysis of SAT, VAT, and the VAT/SAT ratio was calculated. Total body fat was estimated by bioelectric impedance. Linear regression examined differences in fat distribution adjusting for specific covariates (Table). Participants (n=60) at baseline had a mean age of 16.5 yrs and BMI of 42.6 kg/m². Females had significantly higher %body fat (51.2%) vs. males (42.1%), p <0.05. Females also exhibited lower VAT and VAT/SAT ratio compared to males, with no significant race/ethnicity differences in VAT, SAT, or VAT/SAT ratio. Youth prescribed a GLP-1 receptor agonist (RA) had lower VAT (p <0.05) and trended towards lower VAT/SAT (p = 0.07). Female youth with T2D and SO showed higher %body fat, similar SAT, but less VAT vs. males. GLP-1RA use was associated with lower VAT. Future outcomes from the ST₂OMP study will examine if differences in fat distribution occur after MBS.

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