Visceral and Central Abdominal Fat and Anthropometry in Relation to Diabetes in Asian Indians

Abstract

FNASCOBJECTIVE -The objective of the study was to examine body fat distribution using computed tomography (CT), dual-energy X-ray absorptiometry (DEXA), and anthropometry in relation to type 2 diabetes in urban Asian Indians. RESEARCH DESIGN AND METHODS-This is a case-control study of 82 type 2 diabetic and 82 age-and sex-matched nondiabetic subjects from the Chennai Urban Rural Epidemiology Study, an ongoing epidemiological study in southern India. Visceral, subcutaneous, and total abdominal fat were measured using CT, while DEXA was used to measure central abdominal and total body fat. Anthropometric measures included BMI, waist circumference, sagittal abdominal diameter (SAD), and waist-to-hip ratio.RESULTS -Visceral and central abdominal fat showed a strong correlation with each other (P Ͻ 0.0001), and analysis revealed a fairly good agreement between tertiles of visceral and central abdominal fat ( ϭ 0.44, P Ͻ 0.0001). Diabetic subjects had significantly higher visceral (P ϭ 0.005) and central abdominal (P ϭ 0.011) fat compared with nondiabetic subjects. Waist circumference and SAD showed a strong correlation with visceral (P Ͻ 0.01) and central abdominal (P Ͻ 0.0001) fat in both diabetic and nondiabetic subjects. Logistic regression analysis revealed visceral (odds ratio [OR] 1.011, P ϭ 0.004) and central abdominal (OR 1.001, P ϭ 0.013) fat to be associated with diabetes, even after adjusting for age and sex.CONCLUSIONS -Visceral and central abdominal fat showed a strong association with type 2 diabetes. Both measures correlated well with each other and with waist circumference and SAD in diabetic and nondiabetic urban Asian Indians. Diabetes Care 27:2948 -2953, 2004A sian Indians have an increased susceptibility to type 2 diabetes and insulin resistance compared with Europeans (1-4). Recent studies indicate a rising prevalence of diabetes and insulin resistance in India (5-7). Although obesity is a major contributing factor to diabetes, Asian Indians are known to have lower BMIs than Europeans (8). However, for any given BMI, Asian Indians have greater waist-to-hip ratios and abdominal fat (8,9) than Europeans. There are very few studies on fat distribution in Indians (10,11) and virtually none comparing diabetic and nondiabetic subjects. Thus, the first objective of this study was to measure body fat distribution in Asian Indians in relation to type 2 diabetes.Computed tomography (CT) is widely used to assess visceral fat (12-14). Dual-energy X-ray absorptiometry (DEXA) is usually used to measure total body fat (15) but recently has also been used to measure central abdominal fat (16). The association of visceral fat measured by CT and central abdominal fat measured by DEXA has not been studied in an Asian-Indian population, and their relationship with anthropometric variables is also not clear. Thus, the second objective of our study was to correlate visceral and central abdominal fat with each other and with anthropometric parameters. RESEARCH DESIGN ANDMETHODS -This is a case-control study of diabetic...

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