Recent reviews and experimental studies indicate that Japanese adults often develop type 2 diabetes at relatively modest levels of adiposity, frequently with insufficient insulin secretion and a disproportionately high burden of visceral and ectopic fat (fully adjusted HR per 1-unit increase, 2.32; 95% CI, 2.16-2.47), with clear gradients across TyG quartiles in both cohorts. The gene discussed is INS; the disease is type 2 diabetes mellitus.