Evaluation of Abdominal Fat Distribution in Noninsulin-Dependent Diabetes Mellitus: Relationship to Insulin Resistance¹

Abstract

Accumulation of visceral adipose tissue is associated with metabolic complications such as noninsulin-dependent diabetes mellitus. The aim of this study was to evaluate the effect of abdominal adipose tissue on insulin sensitivity in subjects with noninsulin-dependent diabetes mellitus (NIDDM). Areas of abdominal fat were calculated from axial magnetic resonance images obtained at the level of the umbilicus in 21 men with NIDDM [age, 45.6 +/- 8.3 (+/-SD) yr; body mass index, 29.3 +/- 4.5 kg/m(-2); total body fat (skinfold thickness), 26.8 +/- 5.4%; waist to hip ratio, 0.97 +/- 0.07; duration of diabetes, 59 +/- 47 months; hemoglobin A1c, 8.1 +/- 1.5%]. Insulin sensitivity was evaluated by an insulin tolerance test. The areas of deep abdominal fat and sc abdominal fat were, respectively, 135.3 +/- 55.1 and 211.8 +/- 99.1 cm2. The blood glucose disappearance rate was 2.11 +/- 0.87%/min and was negatively related to deep abdominal fat (r = 0.72; P = 0.0025). In contrast, areas of sc abdominal fat, total body fat, body mass index, and waist to hip ratio were not related to the blood glucose disappearance rate. Plasma triglyceride concentrations averaged 1.8 +/- 0.8 mmol/L and were positively related to deep abdominal fat (r = 0.69; P = 0.0018). We conclude that insulin sensitivity is strongly related to visceral adipose tissue accumulation in NIDDM.

Impaired fasting glucose and impaired glucose tolerance in urban population in India

“…It is difficult to estimate 2hBG based on FBG alone, as the former is determined by many variables other than FBG [16]. Post‐load hyperglycaemia is particularly influenced by obesity and visceral obesity [23] and by age [24].…”

Imaging-based characterization of cardiometabolic phenotypes focusing on whole-body MRI—an approach to disease prevention and personalized treatment

“…The first studies focused on the phenotypic characterization of fat distribution in patients with pre-diabetes and diabetes. 15 These studies established the concept of ectopic adipose tissue compartments as excessive accumulations of fat in anatomical areas that do not serve as typical fat-storage depots. 16 Further studies revealed that these ectopic fat depots are associated with a higher risk for the development of metabolic syndrome.…”

“…Specifically, it is now well established that the visceral adipose tissue (VAT) represents an independent risk factor for developing impaired glucose tolerance, diabetes and metabolic syndrome. 15 Similarly, hepatic steatosis (non-alcoholic fatty liver disease) is associated with a higher risk for not only Type 2 diabetes but also the development of cardiovascular complications. 17 The extent of these fat depots has been shown to be independent of simple anthropometric data such as body mass index or waist-to-hip ratios, providing much more differentiated characterization of individual body composition.…”

Methodology, clinical applications, and future directions of body composition analysis using computed tomography (CT) images: A review

“…The role of CT-quantified VAT and SAT areas is of special interest in diseases related to the metabolic syndrome. The CT-quantified VAT area has been shown to be an independent risk factor for diseases related to the metabolic syndrome [126], [127], [128], such as diabetes and insulin resistance [129], [130], hypertension [131], [132], [133], hyperlipidemia [134] and coronary artery and carotid atherosclerosis [135], [136], [137]. A high VAT area was associated with coronary stenosis in asymptomatic patients, independent of other cardiovascular risk factors [138] and linked with the presence of both calcified and noncalcified coronary plaques [139], [138], [140].…”