Abnormal Body Fat Distribution Detected by Computed Tomography in Diabetic Men

Shuman, William P.; Morris, Laura; Leonetti, Donna L.; Wahl, Patricia W.; Moceri, Victoria M.; Moss, Albert A.; Fujimoto, Wilfred Y.

doi:10.1097/00004424-198606000-00007

Cited by 147 publications

(108 citation statements)

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“…A computed tomography (CT) scan at the level of the umbilicus was used to quantify SCF and IAF areas [42]. For this purpose, the border of the intra-abdominal cavity was outlined on the CT image and total fat and IAF areas were quantified by selecting an attenuation range of -250 to −50 Hounsfield units.…”

Section: Methodsmentioning

confidence: 99%

Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex

et al. 2003

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Aims/hypothesis. Increased intra-abdominal fat is associated with insulin resistance and an atherogenic lipoprotein profile. Circulating concentrations of adiponectin, an adipocyte-derived protein, are decreased with insulin resistance. We investigated the relationships between adiponectin and leptin, body fat distribution, insulin sensitivity and lipoproteins. Methods. We measured plasma adiponectin, leptin and lipid concentrations, intra-abdominal and subcutaneous fat areas by CT scan, and insulin sensitivity index (S I ) in 182 subjects (76 M/106F). Results. Adiponectin concentrations were higher in women than in men (7.4±2.9 vs 5.4±2.3 µg/ml, p<0.0001) as were leptin concentrations (19.1±13.7 vs 6.9±5.1 ng/ml, p<0.0001). Women were more insulin sensitive (S I : 6.8±3.9 vs 5.9±4.4×10 −5 min −1 /(pmol/l), p<0.01) and had more subcutaneous (240±133 vs 187±90 cm 2 , p<0.01), but less intra-abdominal fat (82±57 vs 124±68 cm 2 , p<0.0001). By simple regression, adiponectin was positively correlated with age (r=0.227, p<0.01) and S I (r=0.375, p<0.0001), and negatively correlated with BMI (r=−0.333, p<0.0001), subcutaneous (r=−0.168, p<0.05) and intra-abdominal fat (r=−0.35, p<0.0001). Adiponectin was negatively correlated with triglycerides (r=−0.281, p<0.001) and positively correlated with HDL cholesterol (r=0.605, p<0.0001) and Rf, a measure of LDL particle buoyancy (r=0.474, p<0.0001). By multiple regression analysis, adiponectin was related to age (p<0.0001), sex (p<0.005) and intra-abdominal fat (p<0.01). S I was related to intraabdominal fat (p<0.0001) and adiponectin (p<0.0005). Both intra-abdominal fat and adiponectin contributed independently to triglycerides, HDL cholesterol and Rf. Conclusion/interpretation. These data suggest that adiponectin concentrations are determined by intra-abdominal fat mass, with additional independent effects of age and sex. Adiponectin could link intra-abdominal fat with insulin resistance and an atherogenic lipoprotein profile. [Diabetologia (2003) 46:459-469] Keywords Adiponectin, Acrp30, adipoQ, central obesity, subcutaneous fat, intra-abdominal fat, insulin sensitivity, lipids, hepatic lipase, cardiovascular disease, leptin. It is well recognized that obesity and insulin resistance are closely related [1,2,3,4]. Android body fat distribution is associated with insulin resistance more than is a gynoid body fat distribution [5], with the site of abdominal fat distribution being an additional determinant of insulin sensitivity [6,7,8,9,10,11]. We found in both lean and obese subjects that the intraabdominal fat (IAF) depot is a stronger determinant of insulin sensitivity than the subcutaneous fat (SCF) depot [11], while SCF is the main determinant of the plasma concentration of leptin [11], an adipocyte-derived hormone regulating energy metabolism [12,13].

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Section: Methodsmentioning

confidence: 99%

Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex

et al. 2003

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“…The CT image was analyzed for cross-sectional area of fat using a density contour program available in the standard GE computer software as described previously. 49 A single blinded observer made all the CT measurements of intra-abdominal fat.…”

Section: Body Compositionmentioning

confidence: 99%

A Hepatic Lipase Gene Promoter Polymorphism Attenuates the Increase in Hepatic Lipase Activity With Increasing Intra-abdominal Fat in Women

Carr

Hokanson

Deeb

et al. 1999

ATVB

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Abstract-High hepatic lipase (HL) activity is associated with an atherogenic lipoprotein profile of small, dense LDL particles and lower HDL 2 -C. Intra-abdominal fat (IAF) is positively associated with HL activity. A hepatic lipase gene (LIPC) promoter variant (G3 A Ϫ250 ) is associated with lower HL activity, higher HDL 2 -C, and less dense LDL particles.To determine whether the LIPC promoter polymorphism acts independently of IAF to regulate HL, 57 healthy, premenopausal women were studied. The LIPC promoter A allele was associated with significantly lower HL activity (GA/AAϭ104Ϯ34 versus GGϭ145Ϯ57 nmoles ⅐ mL Ϫ1 ⅐ min Ϫ1 , Pϭ0.009 lipolytic enzyme that is a serine hydrolase. It appears to act not only in hydrolysis of triglyceride (TG) and phospholipid in HDL and LDL 1,2 but also as a ligand directing lipoproteins to hepatic cell surface receptors. 3-5 HL is secreted by hepatocytes and anchored to the liver sinusoidal surface by heparin sulfate proteoglycans. 6 The HL gene (LIPC) spans 35 kb of DNA, maps to chromosome 15q21, and is composed of nine exons and eight introns. 7,8 HL plays a role in the metabolic processing of both HDL and LDL. HL acts to convert large, buoyant HDL 2 to small, dense HDL 3 by modulating the phospholipid content of the particle. 9,10 By functioning as a ligand between the lipoprotein and cell surface receptors, HL has been shown to play a role in increased clearance of HDL particles 11,12 and remnant lipoproteins. 13 HL also catalyzes the hydrolysis of triglyceride and phospholipid in large, buoyant LDL forming small, dense more atherogenic LDL particles. 14 Increased risk of premature coronary artery disease (CAD) has been shown to be associated with the presence of small, dense LDL particles. [15][16][17][18][19] Similarly, low HDL-C is another major risk factor for CAD. 20,21 It appears that gender differences in HDL-C levels may account, in part, for the temporal separation in CAD risk between men and women. 20 HDL-C metabolism is modulated by both environmental and genetic factors that combine to account for the significant interindividual variation in HDL-C levels and hence CAD risk. Sedentary lifestyle, 22 tobacco usage, 23 and obesity 24 are all associated with lower HDL-C levels. Forty to sixty percent of the variation in HDL levels appear to be genetic, 25 and Cohen et al have demonstrated genetic linkage between the hepatic lipase promoter (LIPC) locus and HDL-C levels that account for approximately 25% of the interindividual variation in plasma HDL-C levels. 26 HL activity appears to be influenced by several different factors including intra-abdominal fat (IAF), 27 ethnic background, 28,29 sex-steroid hormones, 30 -32 and LIPC genotype. 28,29 Four polymorphisms have now been identified in the 5Ј flanking region of the LIPC gene; a G to A substitution at position Ϫ250, C to T at Ϫ514, T to C at Ϫ710, and A to G at Ϫ763, which appear to be in complete linkage disequilibrium in white populations. 33 The allele frequency of the substitution ranges from 0.15 33 to 0.21 29 ...

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“…Cross-sectional body fat areas (cm 2) were determined by computed tomography at four sites (subcutaneous thorax, subcutaneous abdomen, subcutaneous thigh and intra-abdominal) as previously reported [11,27]. Intraobserver variability ranged from 0.2% of the mean for the thigh to 1.4% of the mean for the thorax [27].…”

Section: Variablesmentioning

confidence: 99%

“…Intraobserver variability ranged from 0.2% of the mean for the thigh to 1.4% of the mean for the thorax [27]. Skinfold thickness (mm) was measured (Lange calipers) on the left side of the body at four different anatomic sites (triceps, biceps, forearm and subscapular).…”

Section: Variablesmentioning

confidence: 99%

Association of plasma triglyceride and C-peptide with coronary heart disease in Japanese-American men with a high prevalence of glucose intolerance

et al. 1990

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Summary. In a community-based study of second-generation Japanese-American men known to have a high prevalence of both Type 2 (non-insulin-dependent) diabetes and impaired glucose tolerance, there was a highly significant association of coronary heart disease with glucose intolerance in a study sample of 219 men. Intra-abdominal cross sectional fat area determined by computed tomography was significantly elevated in men with coronary heart disease even after adjustment for glucose intolerance and body mass index (p = 0.026). Other differences that were significantly related to coronary heart disease after adjustment for glucose intolerance were lower high density lipoprotein cholesterol levels (p = 0.001), elevated total triglyceride and very low density lipoprotein triglyceride (p < 0.001), and elevated fasting insulin and C-peptide levels p = 0.001. When these variables were tested in a stepwise multiple logistic regression model, significant independent associations with coronary heart disease were found only for total triglyceride and fasting C-peptide after adjustment for glucose tolerance status. Variables identified to be associated with coronary heart disease were interpreted as representing or manifesting an insulin resistant state. Thus, insulin resistance may be the underlying risk factor aetiologically linking glucose intolerance with coronary heart disease.

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Abnormal Body Fat Distribution Detected by Computed Tomography in Diabetic Men

Cited by 147 publications

References 0 publications

Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex

Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: evidence for independent roles of age and sex

A Hepatic Lipase Gene Promoter Polymorphism Attenuates the Increase in Hepatic Lipase Activity With Increasing Intra-abdominal Fat in Women

Association of plasma triglyceride and C-peptide with coronary heart disease in Japanese-American men with a high prevalence of glucose intolerance

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