High fat stores in ectopic compartments in men with newly diagnosed type 2 diabetes: an anthropometric determinant of carotid atherosclerosis and insulin resistance

Abstract

Objective: The objective of this study was to analyze how fat partitioning in the liver, muscle and visceral compartments is altered by diabetes and age, and whether altered fat distribution is associated with a higher carotid artery intima-media thickness (C-IMT) and insulin resistance. Methods: This was an observational study performed on 21 young healthy men (mean age±s.d., 28.6±3.8 years) and 73 men with newly developed type 2 diabetes (38 young (29.2 ± 4.1 years) and 35 middle-aged (47.1 ± 6.0 years) subjects). Abdominal visceral and subcutaneous fat areas, mid-thigh muscle attenuation and liver attenuation characteristics were determined; the mid-thigh muscle was divided into low-and normal-density muscle areas. Results: The young and middle-aged diabetic subjects had higher visceral fat areas, higher liver attenuation and higher lipid-rich muscle (greater low-density muscle area and decreased muscle attenuation) when compared with healthy individuals; however, no differences were observed between the two diabetic groups. In contrast, the C-IMT increased with both age and diabetes. On the basis of multiple regression analyses, mid-thigh low-density muscle area and muscle attenuation were independently associated with the C-IMT, and the mid-thigh normal-density muscle area and muscle attenuation were independent factors of insulin resistance. Conclusions: High fat stores within ectopic compartments were observed at an early stage in the development of diabetes. Furthermore, altered lipid partitioning within muscle was independently associated with carotid atherosclerosis and insulin resistance.

Links Between Ectopic Fat and Vascular Disease in Humans

“…53,54 Furthermore, patients with diabetes who had more fat in muscle tissue had greater carotid intima-media thickness than their healthy counterparts. 55 These results provide evidence that intramuscular fat depot is associated with atherosclerosis via increasing insulin resistance independent of overall obesity.…”

Intermuscular Adipose Tissue and Subclinical Coronary Artery Calcification in Midlife

“…Impaired glucose clearance in response to insulin, or insulin resistance, represents a key component in the development of type 2 diabetes and important contributor to cardiovascular risk 18 . Clinical studies have shown that IMAT accumulation is strongly associated with insulin resistance 9,10,13,19 . The present data and previous studies show that IMAT is directly correlated with VAT and PAT volume and the latter are strongly associated with adverse CVD risk factor profiles 20–23 .…”

Premature Atherosclerosis in a Japanese Diabetic Patient with Atypical Familial Partial Lipodystrophy and Hypertriglyceridemia

“…Lipodystrophies are a heterogeneous group of diseases characterized by generalized or partial fat loss (1)(2)(3)(4)(5). Some patients with partial lipodystrophies show fat hypertrophy in other locations.…”