{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:04:36Z","timestamp":1788998676072,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: While sarcopenia has been implicated, we hypothesize that a distinct body composition phenotype, characterized by elevated visceral adiposity and reduced abdominal muscle mass, plays a more critical role in T2DM-related fracture pathogenesis. Methods: In a cross-sectional study of 99 female patients aged \u226565 years who underwent surgery for hip fracture, we compared body composition parameters derived from DXA scans between those with (n = 40) and without (n = 59) T2DM. Key measures included appendicular lean mass index (ALMI), visceral adipose tissue (VAT) mass, android-to-gynoid (A\/G) fat ratio, and a derived measure of relative core lean mass (RCLM). Results: There were no significant differences in ALMI between T2DM and non-DM groups. In contrast, T2DM showed significantly higher central adiposity\u2014A\/G ratio (1.13 \u00b1 0.15 vs. 1.05 \u00b1 0.17; p = 0.0298) and TL fat ratio (1.31 \u00b1 0.22 vs. 1.19 \u00b1 0.23; p = 0.0071)\u2014with VAT estimate numerically higher. Conclusions: In older hip-fracture patients, T2DM was characterized not by appendicular sarcopenia but by central adiposity without significant differences in LMI or RCLM\u2014a phenotype that may contribute to fracture risk through bone-quality and fall-related pathways independent of ALMI.<\/jats:p>","DOI":"10.3390\/jcm15062284","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:41Z","timestamp":1773742901000},"page":"2284","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Visceral Adiposity, Rather than Reduced Appendicular Lean Mass, Characterizes Elderly Hip Fracture Patients with Type 2 Diabetes: A Cross-Sectional DXA Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4166-5790","authenticated-orcid":false,"given":"Hyuna","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-0209","authenticated-orcid":false,"given":"Minkyu","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-7657","authenticated-orcid":false,"given":"Youngkyun","family":"Roh","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8746-3718","authenticated-orcid":false,"given":"Yonghyun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea"},{"name":"Incheon Terminal Orthopedic Surgery Clinic, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"International Academy of Regenerative Medicine, Inha-ro 489beon-gil, Namdong-gu, Incheon 21574, Republic of Korea"},{"name":"International Association of Musculoskeletal Medicine, Kowloon, Hong Kong, China"},{"name":"MSKUS, 1035 E. Vista Way #128, Vista, CA 92084, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9141-9856","authenticated-orcid":false,"given":"Jihyo","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"166","DOI":"10.5312\/wjo.v10.i3.166","article-title":"Changing trends in the mortality rate at 1-year post hip fracture\u2014A systematic review","volume":"10","author":"Downey","year":"2019","journal-title":"World J. 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