Although cardiovascular risk and mortality increases in the presence of comorbid obesity among patients with T2D while fish intake is known to decrease such risks, the association between obesity and fish intake is only poorly understood. Thus, we aimed to clarify these possible associations, including the effects of fish-related nutrients. Analyzed were 1891 Japanese patients with T2D (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. BMI>25 was defined as obesity. Associations between obesity and intake of fish and related nutrients were analyzed by quintiles. Vitamin B12 (VB12) (correlation coefficient, 0.97), vitamin D (VD) (0.94), and long-chain omega-3 polyunsaturated fatty acids (n-3) (0.74) were significantly and potently associated with fish intake. Odds ratio (OR) for obesity was significantly decreased to approximately 0.6 in patients in Q4 (men, 80-108g; women, 77-103g) and Q5 (>108g; >103g) of fish intake compared to Q1 (<37g; <40g) (Table). Intake of all three nutrients showed significant inverse trends with obesity, as did fish intake. Results were unchanged even after additional adjustment by use of medications, including insulin. Dietary instructions for daily fish intake of ≥100g could be provided to decrease the risk of obesity in Japanese patients with T2D. Underlying mechanisms via the related nutrients examined await further investigation. Disclosure M. Hatta: None. K. Fujihara: None. Y. Matsubayashi: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. C. Horikawa: None. N. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.
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