. Abdominal adiposity and insulin resistance in obese men. Am J Physiol Endocrinol Metab 282: E657-E663, 2002; 10.1152/ajpendo.00469.2001.-We examined the independent relationships among various visceral and abdominal subcutaneous adipose tissue (AT) depots, glucose tolerance, and insulin sensitivity in 89 obese men. Measurements included an oral glucose tolerance test (OGTT), glucose disposal by euglycemic clamp, and abdominal and nonabdominal (e.g., peripheral) AT by magnetic resonance imaging (MRI). OGTT glucose and glucose disposal rates were related (P Ͻ 0.05) to visceral AT (r ϭ 0.50 and Ϫ0.41, respectively). These observations remained significant (P Ͻ 0.05) after control for nonabdominal and abdominal subcutaneous AT, and maximal O 2 consumption (V O2 max). Abdominal subcutaneous AT was not a significant correlate (P Ͼ 0.05) of any metabolic variable after control for nonabdominal and visceral AT and V O2 max. Division of abdominal subcutaneous AT into deep and superficial depots and visceral AT into intra-and extraperitoneal AT depots did not alter the observed relationships. Further analysis matched two groups of men for abdominal subcutaneous AT but also for low and high visceral AT. Men with high visceral AT had higher OGTT glucose values and lower glucose disposal rates compared with those with low visceral AT values (P Ͻ 0.05). A similar analysis performed on two groups of men matched for visceral AT but also for high and low abdominal subcutaneous AT revealed no statistically different values for any metabolic variable (P Ͼ 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal and abdominal subcutaneous AT and cardiovascular fitness. Subdivision of visceral and abdominal subcutaneous AT by MRI did not provide additional insight into the relationship between abdominal obesity and metabolic risk in obese men. subcutaneous adipose tissue; insulin sensitivity; visceral adipose tissue DEBATE CONTINUES regarding the independent contribution of abdominal subcutaneous and visceral adipose tissue (AT) toward the etiology of insulin resistance. Whereas some researchers report that visceral AT is the stronger correlate (11,13,15,32), others find that abdominal subcutaneous AT is largely responsible for the established association between abdominal obesity and insulin resistance (1, 2, 19). It has recently been suggested that the discrepancies may be resolved by subdividing abdominal subcutaneous AT according to differences in metabolic characteristics (20,26,38,40). Abdominal subcutaneous AT can be subdivided into superficial and deep compartments by use of the fascia superficialis. The rationale for this division presumes that adipocytes within the deep compartment are more metabolically active compared with superficial adipocytes (12,25). On the assumption that the liberation of nonesterified fatty acids adversely effects insulin action (29, 37), it follows that the deep compartment would be the stronger predictor of insulin resistance. Indeed, Kell...

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