Intra-abdominal fat is associated with decreased insulin sensitivity in healthy young men

Ks, Park; Bd, Rhee; Ku, Lee; Sy, Kim; Lee, Hyun Kyung; Cs, Koh; Hk, Min

doi:10.1016/0026-0495(91)90050-7

Cited by 88 publications

(43 citation statements)

References 22 publications

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“…Some studies have reported that visceral fat is the major determinant of insulin resistance (5,20), but others have suggested that subcutaneous abdominal fat is more important (21,22). Cross-sectional research is also unable to examine the temporal sequence of the development of insulin resistance in relation to visceral fat.…”

Section: Results -Of 139mentioning

confidence: 99%

Visceral Adiposity and the Risk of Impaired Glucose Tolerance

et al. 2003

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OBJECTIVE -Greater visceral adiposity, higher insulin resistance, and impaired insulin secretion increase the risk of type 2 diabetes. Whether visceral adiposity increases risk of impaired glucose tolerance (IGT) independent of other adipose depots, insulin resistance, and insulin secretion is not known. RESULTS -During the 10-to 11-year follow-up period, we confirmed 57 cases of IGT. Significant predictors of IGT included intra-abdominal fat area (IAFA) (odds ratio [OR] for a 1 SD increase 3.82, 95% CI 1.63-8.94 at a fasting plasma glucose [FPG] level of 4.5 mmol/l), HOMA-IR (2.41, 1.15-5.04), IIR (0.30, 0.13-0.69 at an FPG level of 4.5 mmol/l), the interactions of IAFA by FPG (P ϭ 0.003), and IIR by FPG (P ϭ 0.030) after adjusting for age, sex, FPG, and BMI. The multiple-adjusted OR of IAFA increased and that of IIR decreased as FPG level decreased because of these interactions. Even after adjustment for total fat area, total subcutaneous fat area, or abdominal subcutaneous fat area, all of these associations remained a significant predictor of IGT incidence. RESEARCH DESIGN AND METHODSCONCLUSIONS -Greater visceral adiposity increases the risk of IGT independent of insulin resistance, insulin secretion, and other adipose depots in Japanese Americans.

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Section: Results -Of 139mentioning

confidence: 99%

Visceral Adiposity and the Risk of Impaired Glucose Tolerance

et al. 2003

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“…Furthermore, while the amount of visceral fat correlates with the amount of total body fat, visceral obesity and its associated metabolic complications are not only evident in obese subjects. Studies show that visceral fat accumulation also contributes to metabolic risk factors in healthy, nonobese individuals (10,(13)(14)(15). In addition, obese individuals who are "metabolically healthy" have very little visceral fat accumulation (30).…”

Section: Relative Risksmentioning

confidence: 99%

“…In fact, the associations between risk factors and visceral adipose tissue (VAT), measured directly with computed tomography (CT) or magnetic imaging resonance, are stronger than the associations observed with WHR or waist circumference (8 -12). In addition, visceral fat accumulation also contributes to CHD risk factors in healthy, nonobese individuals (10,(13)(14)(15). Thus, the amount of VAT may be the best predictor of obesity-related metabolic complications and could be more clinically relevant than the quantity of total body fat for assessment of risk status.…”

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confidence: 99%

Visceral Adipose Tissue Cutoffs Associated With Metabolic Risk Factors for Coronary Heart Disease in Women

et al. 2003

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OBJECTIVE -This study determined whether there is a critical level of visceral adipose tissue (VAT) associated with elevated coronary heart disease (CHD) risk factors in a cohort of women Ͼ45 years of age.RESEARCH DESIGN AND METHODS -Measurements of body composition (dualenergy X-ray absorptiometry), body fat distribution (computed tomography), fasting and 2-h postprandial (75-g) glucose concentrations, and fasting lipoprotein lipid and insulin concentrations were performed in 233 perimenopausal (9%) and postmenopausal women (age 59 Ϯ 6 years, 79% Caucasian, 16% on hormone replacement therapy).RESULTS -Women in the lowest VAT quintile (Յ105 cm 2 ) had higher concentrations of HDL and HDL 2 cholesterol, lower LDL/HDL cholesterol ratios and triglyceride concentrations, and lower fasting glucose and insulin concentrations than women in the remaining four quintiles (P values Ͻ0.05-0.001). Women in the second lowest VAT quintile (106 -139 cm 2 ) had higher HDL and HDL 2 cholesterol and lower LDL/HDL ratios than women with a VAT Ն163 cm 2 (P Ͻ 0.05). Logistic regression analyses showed that women with a VAT of 106 -162 cm 2 are 2.5 times more likely to have a low HDL cholesterol (P Ͻ 0.05), while women with a VAT Ն163 cm 2 are 5.5 times more likely to have a low HDL cholesterol (P Ͻ 0.01) and ϳ4.0 times more likely to have a high LDL/HDL ratio (P Ͻ 0.05) compared with women with a VAT Յ105 cm 2 . Women with a VAT Ն163 cm 2 are at a higher risk of having impaired glucose tolerance (P Ͻ 0.01).CONCLUSIONS -A VAT Ն106 cm 2 is associated with an elevated risk, and a VAT Ն163 cm 2 with an even greater risk, for these metabolic CHD risk factors compared with women with a VAT Յ105 cm 2 . These values may prove useful for defining "visceral obesity" and for identifying women most likely to benefit from preventative interventions. Diabetes Care 26:1413-1420, 2003O besity is a significant health problem, with nearly one-half of U.S. women and men over 20 years of age considered to be overweight (1). The current criterion used for characterizing individuals as overweight kg/m 2 ) or obese (Ͼ30 kg/m 2 ) were derived from epidemiological evidence showing that the presence of adiposityrelated comorbidities increases abruptly beyond these cut points (2,3). However, obesity is a heterogeneous disorder in that the storage depot for excess calories differs widely between individuals, and these differences in fat distribution confer differential health risks. An excess of fat in the abdominal region is a better predictor of coronary heart disease (CHD) and type 2 diabetes, as well as their risk factors (dyslipidemia, glucose intolerance, and hyperinsulinemia), than the total amount of adipose tissue (4 -7).Most studies designed to assess the health risks of body fat distribution have used anthropometric measures such as waist circumference or waist-to-hip ratio (WHR) to estimate the amount of abdominal adipose tissue. Both of these measures are known independent predictors of metabolic risk factors for CHD in men and women, and it is li...

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“…Several studies on abdominal fat in NW people have found relationships between abdominal fat levels and cardiovascular disease (CVD) or CVD risk factors in NW male subjects [2][3][4] and in some groups of NW female subjects, 5-7 but not in others. 8 However, abdominal fat has been suggested to have a greater role in CVD risk in obese female subjects than in obese male subjects.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in the relationships of abdominal fat to cardiovascular disease risk among normal-weight white subjects

et al. 2003

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The objectives of this study are to investigate the relationships between abdominal fat and risk factors for cardiovascular disease (CVD) among normal-weight (NW) white subjects and to determine how these relationships differ by sex. NW adults (177 males and 258 females) and overweight adults (133 males and 111 females) from the Québec Family Study and the HERITAGE Family Study were retained for this study. Risk factors included systolic and diastolic blood pressures, low-density lipoprotein and highdensity lipoprotein cholesterols, triglycerides, and fasting glucose. Only in NW female adults, abdominal visceral fat (AVF) area assessed by computed tomography was significantly correlated with all risk factors, except for fasting glucose, even after age, study cohort, and fat mass were taken into account. NW female subjects with at least one risk factor had a significantly higher AVF than those without risk factors, although the difference was small. Thus, only NW female adults with more AVF tended to have a more adverse CVD risk factor profile. Keywords: normal-weight; abdominal visceral fat; abdominal subcutaneous fat; cardiovascular disease risk factor; sex differences IntroductionRuderman et al 1 proposed the concept of a 'metabolically obese, normal-weight' (NW) individual and suggested that central obesity (especially elevated abdominal visceral fat, AVF) may be responsible for this clinical profile. Several studies on abdominal fat in NW people have found relationships between abdominal fat levels and cardiovascular disease (CVD) or CVD risk factors in NW male subjects [2][3][4] and in some groups of NW female subjects, 5-7 but not in others. 8 However, abdominal fat has been suggested to have a greater role in CVD risk in obese female subjects than in obese male subjects. 9-11 Hence, some controversy exists regarding sex differences in the role of abdominal fat among NW people. The present study investigated the relationships between indicators of abdominal fat and CVD risk factors in NW individuals and whether there were sex differences in the relationships. Subjects and methodsSubjects were Whites, aged 17-60 years, from Phase 2 of the Québec Family Study (QFS) and from the baseline cohort of the HERITAGE Family Study. Detailed information about the subjects is available in prior publications. [12][13][14] The sample of the present study included NW subjects (177 males and 258 females) and overweight (OW) subjects (133 males and 111 females) using the cut-offs proposed by WHO 15 and NIH. 16 More details about the samples and the methods can be found in a recent paper. 14 Informed (2004) MethodsBody density was measured by the underwater weighing method in the post-absorptive state. Abdominal subcutaneous fat (ASF) and AVF levels were assessed as described elsewhere. 17 The CT scan was performed between the fourth and fifth lumbar vertebrae (L4-L5) with subjects in a supine position and arms stretched above the head. Plasma cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, fasting ...

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Intra-abdominal fat is associated with decreased insulin sensitivity in healthy young men

Cited by 88 publications

References 22 publications

Visceral Adiposity and the Risk of Impaired Glucose Tolerance

Visceral Adiposity and the Risk of Impaired Glucose Tolerance

Visceral Adipose Tissue Cutoffs Associated With Metabolic Risk Factors for Coronary Heart Disease in Women

Sex differences in the relationships of abdominal fat to cardiovascular disease risk among normal-weight white subjects

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