ArticleFrontiers in endocrinology2026
Hidden metabolic obesity phenotypes and risk of incident type 2 diabetes among BMI-defined non-obese adults: a secondary analysis of the NAGALA cohort.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Body mass index (BMI) may fail to capture clinically relevant heterogeneity in adiposity-related diabetes risk, particularly among Asian adults who are not classified as obese. We investigated whether abdominal obesity and fatty liver identify distinct risks of incident type 2 diabetes mellitus (T2DM) among adults with BMI <25 kg/m Methods: This secondary analysis used data from the Japanese NAGALA cohort. A total of 12,940 adults without diabetes at baseline and with BMI <25 kg/m Results: During 78,694.5 person-years of follow-up, 201 incident T2DM events occurred. Incidence rates were 1.70, 2.61, 8.20, and 21.37 per 1,000 person-years across the four phenotypes, respectively. In the fully adjusted model, isolated abdominal obesity was not significantly associated with T2DM (HR 1.47, 95% CI 0.66-3.31), whereas isolated fatty liver (HR 3.43, 95% CI 2.41-4.87) and combined abdominal obesity and fatty liver (HR 8.10, 95% CI 4.65-14.12) were strongly associated with higher risk. Risk increased progressively with the number of non-BMI adiposity components (P for trend <0.001). Associations with fatty liver were observed in both sexes, with no clear evidence of effect modification by sex (P for interaction=0.176), and remained robust in sensitivity analyses, including restriction to BMI <23 kg/m Conclusions: Among BMI-defined non-obese adults, fatty liver-especially when accompanied by abdominal obesity-identified substantial heterogeneity in incident T2DM risk. These findings highlight the limitations of BMI alone for characterizing adiposity-related metabolic risk, while not establishing incremental predictive utility beyond established clinical risk factors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.