Associations of QCT-derived body composition parameters with HOMA-IR-defined metabolic burden in patients with type 2 diabetes mellitus: a retrospective cross-sectional study.
- 1The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China.
- 2Department of Radiology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China. [email protected].
Abstract
Background
Insulin resistance is central to type 2 diabetes mellitus (T2DM) and is linked to abdominal adiposity, ectopic fat deposition, and skeletal muscle metabolism. However, HOMA-IR is a fasting surrogate measure that may be influenced by endogenous insulin secretion and treatment status in established T2DM. This study investigated associations between quantitative computed tomography (QCT)-derived body composition parameters and HOMA-IR-defined metabolic burden.Methods
This retrospective cross-sectional study included 245 patients with T2DM who underwent abdominal QCT. Patients were categorized into low, middle, and high HOMA-IR groups by cohort-specific tertiles; high HOMA-IR was defined as the highest tertile (> 3.95). QCT parameters included visceral fat area (VFA), subcutaneous fat area (SFA), VFA/SFA ratio, intermuscular adipose tissue, skeletal muscle area and skeletal muscle index at L3 (SMI-L3), liver fat content, mean pancreatic fat content, and L1-L2 volumetric bone mineral density. Group comparisons, correlation analyses, and multivariable logistic regression were performed. Sensitivity analyses excluded basal insulin users and analyzed log-transformed HOMA-IR as a continuous outcome.Results
Of the 245 patients, 82, 81, and 82 were assigned to the low, middle, and high HOMA-IR groups, respectively. VFA, SFA, VFA/SFA ratio, SMI-L3, and liver fat content differed significantly across tertiles. HOMA-IR was positively correlated with VFA, SFA, skeletal muscle area at L3, SMI-L3, and liver fat content. In the fully adjusted logistic regression model, VFA showed the largest point estimate for high HOMA-IR (odds ratio [OR] 2.450, 95% confidence interval [CI] 1.665-3.604, P < 0.001). Liver fat content (OR 1.618, 95% CI 1.180-2.217, P = 0.003), SMI-L3 (OR 1.659, 95% CI 1.054-2.611, P = 0.029), and VFA/SFA ratio (OR 1.501, 95% CI 1.065-2.115, P = 0.020) were also associated with high HOMA-IR. In sensitivity analyses, only VFA and liver fat content remained consistently significant.Conclusions
VFA and liver fat content were the most consistent QCT-derived correlates of HOMA-IR-defined metabolic burden in patients with T2DM. Findings for VFA/SFA ratio and SMI-L3 were not reproduced in sensitivity analyses and should therefore be considered exploratory.
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BibTeX
@article{liang2026associations,
title = {{Associations of QCT-derived body composition parameters with HOMA-IR-defined metabolic burden in patients with type 2 diabetes mellitus: a retrospective cross-sectional study.}},
author = {Mei Liang and Shuoqi Dai and Jiahui Yang and Lin Wang},
journal = {BMC endocrine disorders},
year = {2026},
month = aug,
doi = {10.1186/s12902-026-02446-0},
url = {https://europepmc.org/article/MED/42963740},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Associations of QCT-derived body composition parameters with HOMA-IR-defined metabolic burden in patients with type 2 diabetes mellitus: a retrospective cross-sectional study.
AU - Mei Liang
AU - Shuoqi Dai
AU - Jiahui Yang
AU - Lin Wang
PY - 2026
DA - 2026/08/03
JO - BMC endocrine disorders
DO - 10.1186/s12902-026-02446-0
UR - https://europepmc.org/article/MED/42963740
AB - Background Insulin resistance is central to type 2 diabetes mellitus (T2DM) and is linked to abdominal adiposity, ectopic fat deposition, and skeletal muscle metabolism. However, HOMA-IR is a fasting surrogate measure that may be influenced by endogenous insulin secretion and treatment status in established T2DM. This study investigated associations between quantitative computed tomography (QCT)-derived body composition parameters and HOMA-IR-defined metabolic burden.Methods This retrospective cross-sectional study included 245 patients with T2DM who underwent abdominal QCT. Patients were categorized into low, middle, and high HOMA-IR groups by cohort-specific tertiles; high HOMA-IR was defined as the highest tertile (> 3.95). QCT parameters included visceral fat area (VFA), subcutaneous fat area (SFA), VFA/SFA ratio, intermuscular adipose tissue, skeletal muscle area and skeletal muscle index at L3 (SMI-L3), liver fat content, mean pancreatic fat content, and L1-L2 volumetric bone mineral density. Group comparisons, correlation analyses, and multivariable logistic regression were performed. Sensitivity analyses excluded basal insulin users and analyzed log-transformed HOMA-IR as a continuous outcome.Results Of the 245 patients, 82, 81, and 82 were assigned to the low, middle, and high HOMA-IR groups, respectively. VFA, SFA, VFA/SFA ratio, SMI-L3, and liver fat content differed significantly across tertiles. HOMA-IR was positively correlated with VFA, SFA, skeletal muscle area at L3, SMI-L3, and liver fat content. In the fully adjusted logistic regression model, VFA showed the largest point estimate for high HOMA-IR (odds ratio [OR] 2.450, 95% confidence interval [CI] 1.665-3.604, P < 0.001). Liver fat content (OR 1.618, 95% CI 1.180-2.217, P = 0.003), SMI-L3 (OR 1.659, 95% CI 1.054-2.611, P = 0.029), and VFA/SFA ratio (OR 1.501, 95% CI 1.065-2.115, P = 0.020) were also associated with high HOMA-IR. In sensitivity analyses, only VFA and liver fat content remained consistently significant.Conclusions VFA and liver fat content were the most consistent QCT-derived correlates of HOMA-IR-defined metabolic burden in patients with T2DM. Findings for VFA/SFA ratio and SMI-L3 were not reproduced in sensitivity analyses and should therefore be considered exploratory.
SN - 1472-6823
ER -