MON-538 Body Composition Changes in Type 2 Diabetic Women: Differential Effects on Free Fatty Acids and Hepatic Fat Content

Abstract Disclosure: K. Min: None. K. Han: None. Type 2 diabetes (T2D) is characterized by elevated plasma free fatty acid (FFA) levels, which can impair glucose uptake and foster insulin resistance. These FFAs are shuttled to the liver, where they fuel triglyceride synthesis, potentially leading to hepatic steatosis. While weight reduction is generally beneficial for T2D management, the relative impacts of fat loss versus muscle gain remain unclear. Our study aims to elucidate the differential effects of adipose tissue reduction and skeletal muscle hypertrophy on T2D outcomes, providing insights into optimal body composition strategies for disease management. Total 86 Korean women with type 2 diabetes (mean age 55.9 ± 6.9 years, BMI 27.2 ± 2.9 kg/m²) underwent a 12-week lifestyle modification program. Body composition was assessed using dual-energy X-ray absorptiometry (DEXA), while insulin sensitivity (Kitt), serum free fatty acids (FFA), high-sensitivity C-reactive protein (hsCRP), oxidized LDL, and liver density (Hounsfield Units, HU) were measured at baseline and post-intervention. Participants were categorized into four groups based on changes in fat mass (FM) and fat-free mass (FFM): decreased FM & decreased FFM, decreased FM & increased FFM, increased FM & decreased FFM, increased FM & increased FFM. Mean BMI decreased by 2.7% ± 3.1% over the intervention period. Spearman's correlation analysis revealed a significant negative association between FFM change and FFA change (r = -0.359, p = 0.001), and between FM change and liver HU (r = -0.346, p = 0.001). However, no significant differences were observed in FFA, liver HU, hsCRP, or oxidized LDL among the four groups. Additionally, no direct relationships were found between FM, FFM, Kitt, hsCRP, and oxidized LDL. In conclusion, this study suggested that changes in body composition during weight reduction in women with Type 2 Diabetes had distinct metabolic effects. Specifically, increases in fat-free mass were associated with improvements in free fatty acid metabolism, while reductions in fat mass correlated with decrease in hepatic fat content. These findings highlighted the potential importance of both muscle preservation and fat loss in the management of Type 2 Diabetes, though further research is needed to establish causal relationships and clinical significance. Presentation: Monday, July 14, 2025