{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:31:45Z","timestamp":1786422705133,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"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":"\n Background<\/jats:title>\n Type 2 diabetes (T2D) has emerged as a major global public health challenge, with dyslipidemia playing a pivotal role in its pathogenesis. Body fat percentage (BFP), a direct measure of adiposity, surpasses body mass index (BMI) in identifying metabolic risk; however, its prospective association with incident T2D remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To systematically investigate the association between BFP and the risk of incident T2D and to identify potential nonlinear thresholds.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A large-scale retrospective cohort study was conducted involving 15,464 Japanese adults with a mean follow-up of 6.05 years. Cox proportional hazards regression models were employed to estimate hazard ratios (HRs), and restricted cubic spline analyses were performed to assess nonlinear relationships.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n BFP was identified as an independent risk factor for T2D. After comprehensive adjustment for confounders, each 1% increase in BFP corresponded to a 6% increase in T2D risk (HR = 1.06, 95% CI: 1.04\u20131.09). Crucially, restricted cubic spline analysis revealed a significant nonlinear \"hockey-stick\" pattern, identifying an inflection point at 21.65%. Below this threshold, the risk rose sharply with increasing BFP (HR = 1.18, 95% CI: 1.03\u20131.36); above it, the upward trend plateaued. This association remained robust in subgroups with normal waist circumference and absence of fatty liver disease, underscoring BFP's unique utility in detecting normal-weight obesity.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n BFP serves as a crucial predictor of T2D. Maintaining BFP below 21.65% may represent a novel target for personalized diabetes prevention strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1916092","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:20:49Z","timestamp":1786422049000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear association between body fat percent and type 2 diabetes risk in Japanese adults: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaqin","family":"He","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Xuyi Clinical College, Medical College of Yangzhou University","place":["Huai\u2019an, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sha","sequence":"additional","affiliation":[{"name":"Department of Urology, Xuyi Clinical College, Medical College of Yangzhou 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