Abdominal adiposity and insulin resistance in obese men

Abstract

. Abdominal adiposity and insulin resistance in obese men. Am J Physiol Endocrinol Metab 282: E657-E663, 2002; 10.1152/ajpendo.00469.2001.-We examined the independent relationships among various visceral and abdominal subcutaneous adipose tissue (AT) depots, glucose tolerance, and insulin sensitivity in 89 obese men. Measurements included an oral glucose tolerance test (OGTT), glucose disposal by euglycemic clamp, and abdominal and nonabdominal (e.g., peripheral) AT by magnetic resonance imaging (MRI). OGTT glucose and glucose disposal rates were related (P Ͻ 0.05) to visceral AT (r ϭ 0.50 and Ϫ0.41, respectively). These observations remained significant (P Ͻ 0.05) after control for nonabdominal and abdominal subcutaneous AT, and maximal O 2 consumption (V O2 max). Abdominal subcutaneous AT was not a significant correlate (P Ͼ 0.05) of any metabolic variable after control for nonabdominal and visceral AT and V O2 max. Division of abdominal subcutaneous AT into deep and superficial depots and visceral AT into intra-and extraperitoneal AT depots did not alter the observed relationships. Further analysis matched two groups of men for abdominal subcutaneous AT but also for low and high visceral AT. Men with high visceral AT had higher OGTT glucose values and lower glucose disposal rates compared with those with low visceral AT values (P Ͻ 0.05). A similar analysis performed on two groups of men matched for visceral AT but also for high and low abdominal subcutaneous AT revealed no statistically different values for any metabolic variable (P Ͼ 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal and abdominal subcutaneous AT and cardiovascular fitness. Subdivision of visceral and abdominal subcutaneous AT by MRI did not provide additional insight into the relationship between abdominal obesity and metabolic risk in obese men. subcutaneous adipose tissue; insulin sensitivity; visceral adipose tissue DEBATE CONTINUES regarding the independent contribution of abdominal subcutaneous and visceral adipose tissue (AT) toward the etiology of insulin resistance. Whereas some researchers report that visceral AT is the stronger correlate (11,13,15,32), others find that abdominal subcutaneous AT is largely responsible for the established association between abdominal obesity and insulin resistance (1, 2, 19). It has recently been suggested that the discrepancies may be resolved by subdividing abdominal subcutaneous AT according to differences in metabolic characteristics (20,26,38,40). Abdominal subcutaneous AT can be subdivided into superficial and deep compartments by use of the fascia superficialis. The rationale for this division presumes that adipocytes within the deep compartment are more metabolically active compared with superficial adipocytes (12,25). On the assumption that the liberation of nonesterified fatty acids adversely effects insulin action (29, 37), it follows that the deep compartment would be the stronger predictor of insulin resistance. Indeed, Kell...

Metabolic Subtypes and Risk of Mortality in Normal Weight, Overweight, and Obese Individuals with CKD

“…Variability in the metabolic activity of different adipose storage sites may be key to understanding these relationships. Visceral adiposity is more metabolically active than other adipose tissue sites (17) and appears to contribute to many metabolic abnormalities across populations (18)(19)(20)(21)(22)(23)(24)(25)(26). Therefore, it is plausible that excess visceral adipose tissue may partly explain the differential association of obesity with survival in metabolically healthy versus metabolically unhealthy individuals.…”

Is weight loss the optimal target for obesity-related cardiovascular disease risk reduction?

“…Indeed, independent of subcutaneous fat, visceral fat is a strong predictor of dyslipidemia (20,21), glucose tolerance (22,23), insulin resistance (24) and systemic inflammation (25), as well as incidence of hypertension (26), CVD (7), type 2 diabetes (27) and all-cause mortality (28). These observations underscore the notion that both WC and visceral fat should be primary targets for strategies designed to reduce obesity and related CVD risk.…”

Waist circumference and BMI are independently associated with the variation of cardio-respiratory and neuromuscular fitness in young adult men

“…12 Abdominal adiposity (visceral fat and/or subcutaneous abdominal adipose tissue), is an independent and strong predictor of poor health. 13,14 It has also been suggested that waist circumference (WC), a surrogate of abdominal adiposity, could be a better clinical indicator of obesity-related health-risks than BMI. 15 A likely explanation for this is that muscle mass (which is not related to poor health) is partly explaining BMI, while waist is more directly related to both total and abdominal fat mass.…”