{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:39:50Z","timestamp":1792471190955,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp;amp; Metabol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>We characterized body\u2010composition heterogeneity in treatment\u2010naive type 2 diabetes (T2DM) using dual\u2010energy X\u2010ray absorptiometry (DXA), and assessed whether cluster\u2013metabolic associations persisted after accounting for sex\u2010related body\u2010composition differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>K\u2010means clustering of 50 DXA\u2010derived body\u2010composition variables classified 185 treatment\u2010naive T2DM patients. Variance decomposition, sex\u2010stratified analyses, sex\u2010stratified clustering, sex\u2010specific standardization clustering and multiple imputation (20 datasets) addressed sex confounding and missing data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four exploratory body\u2010composition clusters were identified: Low Fat\u2013Low Muscle, Male\u2010Predominant Central Obesity (98.6% male), Female\u2010Predominant Low\u2010Muscle High\u2010Adiposity (98.0% female) and High Fat\u2013High Muscle. Two clusters showed strong sex predominance; sex\u2010specific normalization reduced sex\u2010cluster dependence while preserving metabolic associations. In multiple\u2010imputation\u2010adjusted models, Clusters 2 and 4 had markedly higher MASLD odds (OR\u2009=\u20099.69 and 8.55, respectively), while Cluster 4 had lower osteoporosis (OR\u2009=\u20090.16) and higher hyperuricemia (OR\u2009=\u20096.36) odds versus Cluster 1. Bone turnover markers, diabetic retinopathy and diabetic kidney disease showed no significant associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DXA\u2010based body\u2010composition clusters are associated with distinct metabolic and comorbidity profiles\u2014particularly MASLD, osteoporosis and hyperuricemia\u2014that persisted after sex\u2010specific standardization and multiple imputation. Given the sex\u2013cluster overlap and modest silhouette width, these findings are hypothesis\u2010generating and require prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70366","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:16:12Z","timestamp":1792469772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Composition Phenotypes and Their Metabolic Associations in Treatment\u2010Na\u00efve Patients With Newly Diagnosed Type 2 Diabetes: A\n                    <scp>DXA<\/scp>\n                    \u2010Based Cluster Analysis"],"prefix":"10.1002","volume":"9","author":[{"given":"Xintong","family":"Zhang","sequence":"first","affiliation":[{"name":"Beijing Shijitan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2081-1997","authenticated-orcid":false,"given":"Tao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Beijing Shijitan Hospital Capital Medical University  Beijing China"},{"name":"Department of Endocrinology, Beijing Shijitan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/dmso.S331654"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(18)30051\u20102"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(19)30087\u20107"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20108587(18)30316\u20104"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.956277"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa016"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dcS13\u20102037"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742\u20101241.2008.01805.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature05482"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154\u2010023\u201009796\u20103"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0802929"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018\u2010024\u201005331\u2010y"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/bonekey.2016.48"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13102500"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17930"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.07.038"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13293\u2010021\u201000360\u20109"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2007.01.006"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0026\u20100495(98)90346\u20108"},{"issue":"21","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"3008","DOI":"10.1001\/jama.1991.03470210076036","article-title":"Relationship Between Resistance to Insulin\u2010Mediated Glucose Uptake, Urinary Uric Acid Clearance, and Plasma Uric Acid Concentration","volume":"266","author":"Facchini F.","year":"1991","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20102007\u20101024853"}],"container-title":["Endocrinology, Diabetes &amp; 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