Low Circulating Metrnl Levels are Linked to Higher Abdominal Fat in Elderly T2DM Patients: A Gender-Based Study.

Our study aimed to investigate the association between serum Metrnl levels and body fat distribution in type 2 diabetes mellitus (T2DM) patients. A total of 281 Chinese patients with type 2 diabetes mellitus (T2DM) (195 men and 86 postmenopausal women, aged 61.37 ± 6.50 years, BMI 24.88 ± 3.10 kg/m²) were included in the study. Measurements of body composition were obtained by dual-energy X-ray absorptiometry. Univariate and multivariate regression analyses were adjusted for age, sex, body mass index (BMI), and lipid levels, specifically android (waist/abdominal-dominant) and gynoid (hip/thigh-dominant) fat deposition. Gender-stratified analyses and restricted cubic spline models were employed. Serum Metrnl negatively correlated with A/G ratio (β = -0.01; 95% CI: -0.02~0.00) and android fat (β = -0.77; 95% CI: -1.11~-0.42). After adjustments, associations with A/G and android fat persisted, but not with gynoid fat (P > 0.05). Gender analysis showed stronger correlations in males (A/G: β = -0.02; 95% CI: -0.04~-0.01; android fat: β = -0.85; -1.28~-0.43), but not females. Lower serum levels of Metrnl were significantly associated with increased abdominal adiposity in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), with a more pronounced correlation observed in males. These findings suggest that Metrnl may play a role in regulating abdominal obesity and metabolic dysfunction in this demographic.