Type 2 Diabetes in Obese Individuals Is Associated With Central Adiposity and Atherogenic Dyslipidemia but Does Not Exacerbate Systemic Inflammation: A Cross-Sectional Study

Our findings indicate that, in obese individuals, the presence of T2DM is associated not with a greater degree of overall adiposity, but rather with a distinct metabolic phenotype characterized by centralization of fat distribution and accentuated atherogenic dyslipidemia. The inability of commonly used systemic inflammatory markers to discriminate between groups may be attributed to a "ceiling effect" resulting from the elevated inflammatory background inherent to obesity and the potential "masking effect" of antidiabetic therapies with anti-inflammatory properties in the diabetic cohort. These results underscore the superiority of the WHR over BMI for cardiometabolic risk stratification in obese individuals and highlight the critical importance of treatment history when interpreting inflammatory indices.