Adipose tissue biomarkers and type 2 diabetes incidence in normoglycemic participants in the MESArthritis Ancillary Study: A cohort study

Abstract

Background Given the central role of skeletal muscles in glucose homeostasis, deposition of adipose depots beneath the fascia of muscles (versus subcutaneous adipose tissue [SAT]) may precede insulin resistance and type 2 diabetes (T2D) incidence. This study was aimed to investigate the associations between computed tomography (CT)–derived biomarkers for adipose tissue and T2D incidence in normoglycemic adults. Methods and findings This study was a population-based multiethnic retrospective cohort of 1,744 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with normoglycemia (baseline fasting plasma glucose [FPG] less than 100 mg/dL) from 6 United States of America communities. Participants were followed from April 2010 and January 2012 to December 2017, for a median of 7 years. The intermuscular adipose tissue (IMAT) and SAT areas were measured in baseline chest CT exams and were corrected by height squared (SAT and IMAT indices) using a predefined measurement protocol. T2D incidence, as the main outcome, was based on follow-up FPG, review of hospital records, or self-reported physician diagnoses. Participants’ mean age was 69 ± 9 years at baseline, and 977 (56.0%) were women. Over a median of 7 years, 103 (5.9%) participants were diagnosed with T2D, and 147 (8.4%) participants died. The IMAT index (hazard ratio [HR]: 1.27 [95% confidence interval [CI]: 1.15–1.41] per 1-standard deviation [SD] increment) and the SAT index (HR: 1.43 [95% CI: 1.16–1.77] per 1-SD increment) at baseline were associated with T2D incidence over the follow-up. The associations of the IMAT and SAT indices with T2D incidence were attenuated after adjustment for body mass index (BMI) and waist circumference, with HRs of 1.23 (95% CI: 1.09–1.38) and 1.29 (95% CI: 0.96–1.74) per 1-SD increment, respectively. The limitations of this study include unmeasured residual confounders and one-time measurement of adipose tissue biomarkers. Conclusions In this study, we observed an association between IMAT at baseline and T2D incidence over the follow-up. This study suggests the potential role of intermuscular adipose depots in the pathophysiology of T2D. Trial registration ClinicalTrials.gov NCT00005487

Moderate resistance training reduces intermuscular adipose tissue and risk factors of atherosclerotic cardiovascular disease for elderly patients with type 2 diabetes

“…1 A cohort study involving 1744 participants (average age 69 ± 9 years at baseline) with a 7-year follow-up found that baseline IMAT was associated with the incidence of type 2 diabetes. 8 Elderly patients with diabetes would probably develop sarcopenia because of metabolic changes, reduced activity and impaired nutrient absorption. 9 Sarcopenia is characterized by a decrease in muscle strength and muscle deconditioning, which promotes fatty infiltration and increases IMAT content.…”

“…IMAT levels are higher in men and women with type 2 diabetes mellitus and metabolic syndrome compared with those without these conditions 1 . A cohort study involving 1744 participants (average age 69 ± 9 years at baseline) with a 7‐year follow‐up found that baseline IMAT was associated with the incidence of type 2 diabetes 8 …”

Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study

“…Further research is therefore warranted to examine long-term habitual ArtSw exposures and adiposity outcomes, including anthropometry and specific AT compartment volumes. Visceral and skeletal muscle compartments are of particular interest, given their consistent associations with greater risks of incident type 2 diabetes [ 11 – 13 ] and clinical or subclinical coronary heart disease [ 14 – 16 ]—in contrast to the mixed results observed for subcutaneous AT compartment volumes [ 11 , 17 ].…”