What question did this study set out to answer?

Investigate diabetes risk differences across racial groups while adjusting for visceral adipose tissue.

February 9, 2026Journal of the Endocrine Society1 citationsOpen Access

Visceral Adiposity Does Not Explain Increased Diabetes Rates in Black and Hispanic People in NHANES 2011-2018

LALeah S. AlemuUniversity of Chicago KCKarishma ChopraNorthwell Health RJRajesh JainUniversity of Chicago

Key Points

Investigate diabetes risk differences across racial groups while adjusting for visceral adipose tissue.
Analyzed NHANES data from 2011-2018 for individuals aged 18-59.
Used questionnaires and total body DXA for VAT measurement.
Defined diabetes mellitus as A1c ≥6.5% or self-report.
Calculated adjusted odds ratios for diabetes by race.
Black and Hispanic individuals had higher odds of diabetes compared to White individuals (OR 1.77-2.38).
White individuals had the lowest diabetes rates at 5.6%.
Higher visceral adiposity was associated with diabetes more strongly in Asian individuals compared to White individuals (OR 1.54 vs 1.27).
The association between visceral adipose tissue and diabetes remained significant across racial groups.

Abstract

Abstract Context Asian (AS), Black (BL), and Hispanic (HIS) individuals in the United States have higher rates of diabetes mellitus (DM) when compared to White (WH) individuals. It is not clear if these differences could be related to visceral adipose tissue (VAT). Objective To investigate the risk of diabetes across racial groups while adjusting for differences in VAT. Our secondary objective was to examine the association of VAT on the risk of diabetes and assess for differences by race. Methods Participants aged 18-59 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 underwent questionnaires, hemoglobin A1c testing, and total body DXA with VAT measurement. DM was defined by A1c ≥6.5% or self-report. We analyzed the odds ratio of DM by race with and without controlling for body composition. Results Among 1,431 AS, 1,992 BL, 2,302 HIS, and 3,482 WH, WH had the lowest rates of DM (5.6%). Among those with DM, WH had the highest VAT (914 g ± 232 g). AS, BL, and HIS had higher odds of DM compared to WH when controlling for covariates (OR 1.77-2.38, P0.05), and these associations were unchanged or strengthened when controlling for body composition. However, there was a stronger association between VAT and DM in AS versus WH (OR 1.54 vs OR 1.27 per 100 g increase in VAT, p-for-interaction=0.004). Conclusion VAT does not explain the higher rates of DM among BL and HIS compared to WH. Other biological and non-biological factors need further study to better understand this disparity.

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