{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:38:24Z","timestamp":1783021104133,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"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":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the association between obesity, defined using population\u2010specific body mass index (BMI) thresholds, and peripheral neuropathy across the glucose tolerance spectrum in Japanese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study included 353 Japanese adults: 90 with normal glucose tolerance (NGT), 55 with impaired glucose tolerance (IGT), and 208 with type 2 diabetes mellitus. Participants were stratified by BMI (&lt;25 vs \u226525\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) according to Japan Society for the Study of Obesity criteria. Peripheral neuropathy was assessed using the Neuropathy Disability Score, nerve conduction studies, quantitative sensory testing, and corneal confocal microscopy (CCM). Associations between BMI and neuropathy measures were examined using regression models adjusted for age and sex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BMI\u2010related differences in neuropathy measures were predominantly confined to participants with type 2 diabetes mellitus. Within this group, higher BMI was associated with greater neuropathy severity (adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01) and a higher prevalence of Toronto\u2010defined neuropathy (adjusted odds ratio 3.3, 95% CI 1.4\u20137.7;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). In contrast, obesity was not independently associated with neuropathy measures in NGT or IGT participants. Corneal nerve fiber length was significantly reduced in IGT compared with NGT (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating early small\u2010fiber involvement related to glycemic status rather than adiposity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Japanese adults, obesity at population\u2010specific BMI thresholds exacerbates peripheral neuropathy primarily in established type 2 diabetes mellitus. Early small\u2010fiber abnormalities are detectable in IGT and appear driven by glucose dysregulation rather than obesity alone. These findings highlight population\u2010specific patterns of neuropathy risk and support early identification of nerve involvement across the glucose tolerance spectrum in East Asian populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70319","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:05:57Z","timestamp":1778659557000},"page":"1142-1153","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body mass index and peripheral neuropathy across the glucose tolerance spectrum in Japanese adults"],"prefix":"10.1111","volume":"17","author":[{"given":"Fukashi","family":"Ishibashi","sequence":"first","affiliation":[{"name":"Internal Medicine Ishibashi Medical and Diabetes Centre  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiko","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Internal Medicine Ishibashi Medical and Diabetes Centre  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harumi","family":"Uetake","sequence":"additional","affiliation":[{"name":"Internal Medicine Ishibashi Medical and Diabetes Centre  Hiroshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren C.","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Leeds Institute for Data Analytics, School of Medicine University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"G\u00fcdemann","sequence":"additional","affiliation":[{"name":"Exeter Diabetes Centre of Excellence (EXCEED), Diabetes and Vascular Research Centre, National Institute for Health Research (NIHR), Exeter Clinical Research Facility University of Exeter Medical School  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Fadavi","sequence":"additional","affiliation":[{"name":"Exeter Diabetes Centre of Excellence (EXCEED), Diabetes and Vascular Research Centre, National Institute for Health Research (NIHR), Exeter Clinical Research Facility University of Exeter Medical School  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-1543","authenticated-orcid":false,"given":"Mitra","family":"Tavakoli","sequence":"additional","affiliation":[{"name":"Exeter Diabetes Centre of Excellence (EXCEED), Diabetes and Vascular Research Centre, National Institute for Health Research (NIHR), Exeter Clinical Research Facility University of Exeter Medical School  Exeter 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