Higher Prevalence of Type 2 Diabetes in Men Than in Women Is Associated With Differences in Visceral Fat Mass

Context: We have previously found that visceral fat is a stronger predictor for cardiovascular risk factors than body mass index (BMI). Objective: This study sought to investigate the prevalence of diabetes in elderly men and women in relation to objectively assessed visceral fat volume. Design and Setting: The cohort consisted of a population-based sample of 705 men and 688 women, all age 70 y at the time of examination. Main Outcome Measures: Associations between body fat estimates, plasma glucose level, and diabetes prevalence were investigated using multivariable-adjusted statistical models. Results: The prevalence of type 2 diabetes was 14.6% in men and 9.1% in women (P < .001). Mean BMI was slightly higher in men than in women(27.3 vs 26.6 kg/m(2); P = .01), with a greater difference in mean visceral fat mass (1987 vs 1077 g; P < .001). After adjustment for physical activity and smoking, men had about/approximately twice the odds of having type 2 diabetes compared with women (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.38-2.76). The inclusion of BMI in this model did not change the risk associated with male sex (OR, 1.93; 95% CI, 1.34-2.77). However, when visceral fat was included as a covariate, male sex was not associated with increased risk of type 2 diabetes (OR, 0.77; 95% CI, 0.51-1.18). Conclusions: The higher prevalence of type 2 diabetes in older men than in older women was associated with larger amount of visceral fat in men. In contrast, differences in BMI was not associated with this difference.