Regional adiposity and risk for coronary artery disease in type 1 diabetes: Does having greater amounts of gluteal-femoral adiposity lower the risk?

AimsEvidence suggests that the degree of gluteal-femoral adiposity may be inversely associated with coronary artery disease (CAD) risk; however, this association has not been evaluated in type 1 diabetes (T1D).MethodsThe relationship between regional adiposity, cardiovascular risk factors, and presence of CAD was examined in participants from the Pittsburgh Epidemiology of Diabetes Complications (EDC) study using data collected from the 18-year exam (n = 163). Total and regional adiposity was assessed by dual X-ray absorptiometry (DEXA).ResultsParticipants with CAD exhibited lower % leg fat mass (FM) (33.42 vs. 36.96, p = 0.006) and higher % trunk FM (48.33 vs. 45.18, p = 0.02), respectively, after adjusting for age, sex, height, and total adiposity compared to those without CAD. Multivariate logistic regression analyses revealed that in females, every 1 SD increase in % leg FM was associated with an approximate 60% reduction in CAD risk (OR = 0.40, 95% CI 0.16–0.99). Higher % trunk FM was also associated with greater risk of CAD prevalence in females (OR = 2.79, 95% CI 1.08–7.20 per SD change). These associations were not observed in males.ConclusionsThis is novel evidence that DEXA-assessed lower body adiposity is inversely associated with CAD in T1D, however, this association seems to only exist in females.