en Epidemiology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:14pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> Diabetes mellitus and obesity are major public health concerns in older adults, and visceral adipose tissue (VAT) is suggested to play a critical role in the metabolic dysfunction observed in type 2 diabetes. This cross-sectional study investigated the relationship between VAT and other obesity-related indicators with type 2 diabetes mellitus in elderly adults in northern Iran.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Methods:</span></i></b> Participants aged 60 years and older were included, comprising 300 individuals with diabetes and 600 controls for comparative analysis, matched by age and sex. Demographic characteristics, physical activity, anthropometric measures, fasting blood sugar (FBS), and lipid profile were assessed. VAT and other body fat parameters were measured using dual-energy x-ray absorptiometry (DXA). Statistical analyses including t-tests, Pearson correlation, and ROC curve analysis were performed.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Results:</span></i></b> The diabetic group had a significantly higher VAT mass (954.54&plusmn;319.82 vs. 831.95&plusmn;323.20, p <0.001) and volume (1031.92&plusmn;345.79 vs. 899.38&plusmn;349.43, p <0.001) than controls, while total body fat mass and percentage were not significantly different in between groups (p = 0.052, 0.878; respectively). FBS showed positive correlation with VAT metrics (r = 0.127, p < 0.001). VAT mass and volume yielded the highest AUCs (0.605, 95% CI: 0.567&ndash;0.644, p < 0.001) for diabetes discrimination.</span><br> <span style="line-height:14pt"><b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> Our findings support the significant association of VAT and diabetes in older adults, in contrast to general fat measures.&nbsp;However, discriminatory power of VAT remained poor to inconclusive in our study, especially in older women. Further analysis is needed to clarify the clinical utility of VAT in screening and prevention.</span></span></span><br> &nbsp; Diabetes, Elderly, Visceral fat mass, Visceral fat volume, Obesity, Body mass index, Waist circumference 659 670 http://caspjim.com/browse.php?a_code=A-10-95-6&slc_lang=en&sid=1 Mohammad Moslemi mohannad.moslemi.011@gmail.com 100319475328460057933 100319475328460057933 No Student Research Committee, Babol University of Medical Sciences, Babol, Iran Marjan Mouodi marjan_mouodi@yahoo.com 100319475328460057934 100319475328460057934 No Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran Seyed Reza Hosseini hosseinim46@yahoo.com 100319475328460057935 100319475328460057935 No Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Reza Ghadimi rezaghadimi@yahoo.com 100319475328460057936 100319475328460057936 No Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Nasim Hosseinzadeh nasimhosseinzadeh79@gmail.com 100319475328460057937 0009-0007-5604-4044 No Cancer Research Center, Babol University of Medical Sciences, Babol, Iran Ali Bijani alibijani@yahoo.com 100319475328460057938 100319475328460057938 Yes Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran