{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T07:06:10Z","timestamp":1788937570815,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["EH6\u2010201135"],"award-info":[{"award-number":["EH6\u2010201135"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["ISA\u2010181192"],"award-info":[{"award-number":["ISA\u2010181192"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT 183957"],"award-info":[{"award-number":["PJT 183957"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n Although diabetes typically arises in middle\u2010aged, overweight\/obese individuals, African populations exhibit disproportionately elevated prevalence rates in young adults with underweight or normal weight. However, little is known about the contribution of adiposity to diabetes in this context. We thus sought to characterise the relationships between body composition and A1c in young African women newly\u2010diagnosed with diabetes in the setting of underweight, normal weight and overweight\/obesity.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Baseline assessment for a trial identified 379 women (median age 22.4\u2009years; median A1c 7.0%) with previously undiagnosed diabetes in Soweto, South Africa. Women were stratified into BMI categories of overweight\/obese (BMI \u2265\u200925;\n n<\/jats:italic>\n \u2009=\u2009192), normal weight (18.5\u2009\u2264\u2009BMI\u2009<\u200925;\n n<\/jats:italic>\n \u2009=\u2009158), and underweight (BMI\u2009<\u200918.5;\n n<\/jats:italic>\n \u2009=\u200929), and underwent Dual Energy X\u2010ray Absorptiometry (DEXA) scanning to evaluate total and regional adiposity.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All body composition measures progressively increased from underweight to normal weight to overweight\/obese (all\n p<\/jats:italic>\n \u2009<\u20090.001), whereas A1c did not differ between the groups. Fat mass, gynoid fat, trunk fat, and leg fat were each associated with A1c in underweight diabetes (all\n r<\/jats:italic>\n \u2009\u2265\u20090.48,\n p<\/jats:italic>\n \u2009\u2264\u20090.01) but not in normal weight or overweight\/obese groups. Upon covariate adjustment, fat mass (\n \u03b2<\/jats:italic>\n \u2009=\u20090.18,\n p<\/jats:italic>\n \u2009=\u20090.007), gynoid fat (\n \u03b2<\/jats:italic>\n \u2009=\u20090.77,\n p<\/jats:italic>\n \u2009=\u20090.03), trunk fat (\n \u03b2<\/jats:italic>\n \u2009=\u20090.46,\n p<\/jats:italic>\n \u2009=\u20090.01), and leg fat (\n \u03b2<\/jats:italic>\n \u2009=\u20090.30,\n p<\/jats:italic>\n \u2009=\u20090.01) were each independently associated with A1c in underweight diabetes, with no such associations in normal weight and overweight\/obese groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In young South African women with newly\u2010diagnosed diabetes, adiposity relates to A1c only in those who are underweight, but paradoxically not in those with normal weight or overweight\/obesity, potentially suggestive of biologic differences from diabetes in other populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71333","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:06:13Z","timestamp":1788933973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual Energy X\u2010Ray Absorptiometry Reveals Differential Glycemic Implications of Adiposity in Underweight, Normal Weight, and Overweight South African Women With Newly\u2010Diagnosed Diabetes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1989-027X","authenticated-orcid":false,"given":"Ravi","family":"Retnakaran","sequence":"first","affiliation":[{"name":"Leadership Sinai Centre for Diabetes Mount Sinai Hospital Toronto Canada"},{"name":"Division of Endocrinology University of Toronto Toronto Canada"},{"name":"Lunenfeld\u2010Tanenbaum Research Institute Mount Sinai Hospital Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-0550","authenticated-orcid":false,"given":"Junwei","family":"Shen","sequence":"additional","affiliation":[{"name":"Leadership Sinai Centre for Diabetes Mount Sinai Hospital Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayjean J.","family":"Hung","sequence":"additional","affiliation":[{"name":"Lunenfeld\u2010Tanenbaum Research Institute Mount Sinai Hospital Toronto Canada"},{"name":"Prosserman Centre for Population Health Research Sinai Health System Toronto Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K.","family":"Micklesfield","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Ageing African Adult Research Unit, Department of Paediatrics University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Lye","sequence":"additional","affiliation":[{"name":"Lunenfeld\u2010Tanenbaum Research Institute Mount Sinai Hospital Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A.","family":"Norris","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Ageing African Adult Research Unit, Department of Paediatrics University of the Witwatersrand Johannesburg South Africa"},{"name":"School of Human Development and Health University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"issue":"8","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S2213-8587(17)30181-X","article-title":"Diabetes in Sub\u2010Saharan Africa: From Clinical Care to Health Policy","volume":"5","author":"Atun R.","year":"2017","journal-title":"Lancet Diabetes and Endocrinology"},{"issue":"10","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"e1375","DOI":"10.1016\/S2214-109X(19)30374-2","article-title":"Burden of Non\u2010Communicable Diseases in Sub\u2010Saharan Africa, 1990\u20102017: Results From the Global Burden of Disease Study 2017","volume":"7","author":"Gouda H. 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