Role of adipose tissue compartments for cardiovascular risk in diabetes endotypes

figure

posted on 2025-06-17, 16:03 authored by Oana-Patricia Zaharia, Yuliya Kupriyanova, Pavel Bobrov, Christian Binsch, Birgit Knebel, Tim Mori, Iryna Yurchenko, Dania Marel Mendez Cardenas, Theresa Kössler, Nina Trinks, Martin Schön, Kálmán B Bódis, Robert Wagner, Vera Schrauwen-Hinderling, Michael Roden

Objective: The severe insulin-resistant diabetes (SIRD) endotype associates with metabolic dysfunction-associated steatotic liver disease and higher cardiovascular risk. We investigated whether skeletal muscle or adipose tissue lipids are elevated in SIRD.

Research design and Methods: Participants (n=420) of the German Diabetes Study (GDS) were assigned to diabetes clusters using a validated algorithm (www.diabetescalculator.ddz.de). 1H-magnetic resonance methods were used for quantifying intramyocellular (IMCL), intrahepatic lipids (IHL) and visceral (VAT) and subcutaneous adipose tissue (SAT) volumes.

Results: Aside from elevated IHL (p<0.01), SIRD showed higher VAT and SAT than other endotypes after adjustment for BMI (all p<0.05), but not for multiple comparisons. All endotypes featured comparable IMCL. VAT and IHL correlated with cardiovascular risk scores (Framingham, r=0.661, r=0.548, p<0.05). Polygenic risk scores for VAT associated with higher cardiovascular risk.

Conclusions: SIRD features higher IHL and nominally higher VAT, which likely contributes to increased cardiovascular risk, highlighting implications for tailored prevention and treatment.