We have previously found that visceral fat is a stronger predictor for cardiovascular risk factors than body mass index (BMI).

This study sought to investigate the prevalence of diabetes in elderly men and women in relation to objectively assessed visceral fat volume.

The cohort consisted of a population-based sample of 705 men and 688 women, all age 70 y at the time of examination.

Associations between body fat estimates, plasma glucose level, and diabetes prevalence were investigated using multivariable-adjusted statistical models.

The prevalence of type 2 diabetes was 14.6% in men and 9.1% in women (P < .001). Mean BMI was slightly higher in men than in women (27.3 vs 26.6 kg/m²; P = .01), with a greater difference in mean visceral fat mass (1987 vs 1077 g; P < .001). After adjustment for physical activity and smoking, men had about/approximately twice the odds of having type 2 diabetes compared with women (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.38–2.76). The inclusion of BMI in this model did not change the risk associated with male sex (OR, 1.93; 95% CI, 1.34–2.77). However, when visceral fat was included as a covariate, male sex was not associated with increased risk of type 2 diabetes (OR, 0.77; 95% CI, 0.51–1.18).

The higher prevalence of type 2 diabetes in older men than in older women was associated with larger amount of visceral fat in men. In contrast, differences in BMI was not associated with this difference.