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Aim  Diabetes mellitus (DM) is associated with adverse outcomes, and visceral adipose tissue (VAT), classified into intraperitoneal VAT (IVAT) and retroperitoneal VAT (RVAT), is associated with insulin resistance. This study aimed to evaluate the association of IVAT and RVAT with the prevalence or incidence of DM.    Methods  In this cross-sectional, retrospective, cohort study, the prevalence and incidence of DM was analyzed in 803 and 624 middle-aged Japanese participants, respectively. The cross-sectional area of the abdominal adipose tissue was evaluated from an unenhanced computed tomography scan at the third lumbar vertebrae, and the IVAT or RVAT was analyzed using specialized software. The areas were normalized for the square value of the participants’ height in meters and described as the IVAT or RVAT area index.    Results  The IVAT area index (adjusted odds ratio [OR], 1.04; 95% confidence intervals [CI], 1.02–1.07, per 1.0 cm 2 /m 2 ) or IVAT/RVAT area ratio (1.89; 1.23–2.85, per 1.0) was independently associated with the prevalence of DM, whereas the RVAT area index was not. During a follow-up (mean) of 3.7 years, 30 participants were diagnosed with DM. The IVAT area index (adjusted hazards ratio [HR], 1.02; 95% CI 1.003–1.04, per 1.0 cm 2 /m 2 ) or IVAT/RVAT area ratio (2.25; 1.40–3.43, per 1.0) was independently associated with the incidence of DM, whereas the RVAT area index was not.    Conclusions  IVAT, but not RVAT, is associated with the prevalence or incidence of DM.

diabetology and metabolic syndrome

Intraperitoneal, but not retroperitoneal, visceral adipose tissue is associated with diabetes mellitus: a cross-sectional, retrospective pilot analysis