{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:05:07Z","timestamp":1780031107791,"version":"3.53.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Residual cholesterol (RC) is linked to cardiovascular risk, yet the optimal adiposity indices to capture this burden in type 2 diabetes (T2D) remain unclear. We compared associations of general and central adiposity indices with RC in a real-world T2D cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 1,135 adults with T2D at a Chinese Metabolic Management Centre (2022\u20132025). We assessed BMI, weight, waist circumference (WC), waist-to-height ratio (WHtR), visceral fat area (VFA), subcutaneous fat area (SFA), and VFA\/SFA ratio. Linear regression estimated \u03b2 coefficients for RC per 1-SD increase in indices, adjusted for age, sex, HbA1c, eGFR, blood pressure, smoking, and drinking. Nonlinearity was assessed using generalized additive models and piecewise regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across RC quartiles, patients with higher RC were more often male and current smokers and had higher BMI, WC, VFA, SFA, WHtR and VFA\/SFA. In unadjusted models, all adiposity indices were positively associated with RC, but after full adjustment only VFA (\u03b2 0.1102, 95% CI 0.0186\u20130.2018) and VFA\/SFA (\u03b2 0.1882, 95% CI 0.1010\u20130.2753) remained independently related to RC. When modelled in original units and quartiles, the highest VFA quartile was associated with 0.383 mmol\/L (95% CI 0.131\u20130.636) higher RC and the highest VFA\/SFA quartile with 0.562 mmol\/L (95% CI 0.316\u20130.808) higher RC compared with the lowest quartile in fully adjusted models. A non-linear association between VFA\/SFA and RC was observed, with an inflection around 0.72: below this threshold, higher VFA\/SFA was strongly associated with higher RC (\u03b2 1.61, 95% CI 0.91\u20132.30), whereas no clear association was seen above it. Subgroup analyses showed broadly consistent associations across age, sex, BMI and HbA1c strata, without significant interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In T2D, indices of visceral fat accumulation\u2014particularly VFA and VFA\/SFA\u2014are more strongly associated with RC than BMI, WC, or WHtR. A VFA\/SFA ratio near 0.7\u20130.8 may mark a critical range where visceral fat predominance is most strongly linked to RC elevation. Detailed visceral adiposity assessment may help refine RC-related risk stratification beyond traditional measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1848101","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:48:25Z","timestamp":1780030105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Visceral fat area and visceral-to-subcutaneous fat ratio are more strongly associated with residual cholesterol than conventional anthropometric indices in adults with type 2 diabetes"],"prefix":"10.3389","volume":"17","author":[{"given":"Zichen","family":"Rao","sequence":"first","affiliation":[{"name":"Department of Endocrinology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital","place":["Quzhou, Zhejiang, 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Endocrinology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital","place":["Quzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital","place":["Quzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s Hospital","place":["Quzhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People\u2019s 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