PHENOEINDY-2 — Non-Autoimmune Lean Diabetes in Young Indians from Assam

Key finding

DEXA body composition measurement revealed what BMI concealed: 53% of lean diabetic patients had body fat >25% — the thin-fat phenotype confirmed at scale. Despite lean BMIs, these individuals had higher waist-hip ratio, higher truncal fat, and higher body roundness index compared with White Americans at the same BMI. Beta-cell function was severely compromised: median HOMA-B 25.7 in cases vs 68.3 in controls — a roughly 63% reduction in beta-cell reserve. HOMA-S was 103 vs 182 (moderate insulin resistance), confirming that both the Fragile Engine and the Overflow Tank are simultaneously compromised. All three core Zinda Framework mechanisms — beta-cell depletion, visceral fat excess at lean weight, and the adiponectin-linked fat quality deficit — are operating in the same lean young patients. ---

Framework connections: The Fragile Engine, The Overflow Tank, The Adiponectin Deficit

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