Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM

Carey, David; Jenkins, A. B.; Campbell, Lesley V.; Freund, Judith; Chisholm, Donald J.

doi:10.2337/diabetes.45.5.633

Cited by 282 publications

(263 citation statements)

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“…Of note, these associations exist not only in morbidly obese, but also in non-obese individuals, indicating that accumulation of visceral fat reduces its ability to dampen oxidative stress and interferes with insulin sensitivity already in the lean individuals. 36 The negative correlation of relative visceral HMOX1 expression and HOMA-IR is evident only in insulin-resistant subjects. The fact that visceral HMOX1 expression did not correlate with HOMA-IR in insulin- Adipose heme oxygenase-1 and insulin sensitivity S Shakeri-Manesch et al sensitive subjects does not necessarily mean that heme oxygenase-1 is not important for insulin sensitivity in such individuals, but suggests that more exact measures of insulin sensitivity, particularly hyperinsulinemic euglycemic clamp testing, should be applied to estimate the putative role of visceral heme oxygenase-1.…”

Section: Discussionmentioning

confidence: 99%

Diminished upregulation of visceral adipose heme oxygenase-1 correlates with waist-to-hip ratio and insulin resistance

et al. 2009

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Objective: Insulin resistance in visceral obesity is substantially driven by adipose tissue inflammation, particularly by macrophages accumulating in obese adipose tissue. In contrast, adipose tissue macrophages express the hemoglobin scavenger receptor (CD163) and heme oxygenase-1 (gene: HMOX1) that together protect from oxidative stress. Our aim was to evaluate the expression of CD163 and HMOX1 in intra-abdominal visceral (omental) and subcutaneous adipose tissue as well as circulating soluble CD163 concentrations in human obesity and its association with adipose tissue inflammation, body fat distribution and insulin resistance. Methods: CD163, HMOX1 and CD68 mRNA expression in visceral and subcutaneous adipose tissue, serum concentration of soluble CD163 in morbidly obese patients (body mass index (BMI) 440 kg m À2 ), who underwent laparoscopic surgery for gastric banding (n ¼ 20), matched for age and sex to controls (BMIo30 kg m À2 ; n ¼ 20) was analyzed. Results: CD163 expression was highly upregulated in human adipose tissue and soluble CD163 serum concentration was elevated in obese vs lean subjects. HMOX1 was upregulated in adipose tissue by obesity as well and expressed predominantly in macrophages. Although CD163 expression strictly correlated with macrophage abundance, HMOX1 was additionally upregulated within macrophages. This upregulation was significantly lower in visceral compared with subcutaneous adipose tissue. Strikingly, relative visceral adipose tissue expression of HMOX1 negatively correlated with waist-to-hip ratio and the homeostasis model assessment of insulin resistance (both P ¼ 0.024). Conclusions: Visceral obesity is associated with defective upregulation of heme oxygenase-1 in visceral adipose tissue. A lack of this antioxidative and anti-inflammatory enzyme in visceral adipose tissue could contribute to the development of insulin resistance.

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Section: Discussionmentioning

confidence: 99%

Diminished upregulation of visceral adipose heme oxygenase-1 correlates with waist-to-hip ratio and insulin resistance

et al. 2009

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“…Although this window contains both intra-abdominal fat and subcutaneous abdominal fat, it excludes 30% of the latter, has a relatively high intra-abdominal and low subcutaneous abdominal fat content, and has been shown to be strongly inversely related to insulin sensitivity assessed by the euglycemichyperinsulinemic clamp. Our group has previously demonstrated a CV of less than 6% for central abdominal fat, based on data from 10 female subjects scanned on four separate Neuropeptides 45(4): 301--307, 2011 occasions (Carey et al, 1996). Central abdominal fat mass measured by DXA correlates highly with visceral fat mass measured by other methods such as MRI and CT, and has been validated previously (Park et al, 2002 andStewart et al, 2003).…”

Section: Body Compositionmentioning

confidence: 70%

“…As previously described (Carey et al, 1996), a central abdominal window was outlined manually extending from the upper border of L2 to the lower border of L4 and laterally to the outer margin of the rib cage. The fat in this window was measured and expressed as mass (central abdominal fat in kilograms) and as percentage of the total soft tissue content in this area.…”

Section: Body Compositionmentioning

confidence: 99%

In adults with Prader–Willi syndrome, elevated ghrelin levels are more consistent with hyperphagia than high PYY and GLP-1 levels

et al. 2011

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ObjectivePrader-Willi syndrome (PWS) is a leading genetic cause of obesity, characterized by hyperphagia, endocrine and developmental disorders. It is suggested that the intense hyperphagia could stem, in part, from impaired gut hormone signaling. Previous studies produced conflicting results, being confounded by differences in body composition between PWS and control subjects. Design Fasting and postprandial gut hormone responses were investigated in a cross-sectional cohort study including 10 adult PWS, 12 obese subjects matched for percentage body fat and central abdominal fat, and 10 healthy normal weight subjects. Methods PYY [total], PYY , GLP-1[active] and ghrelin [total] were measured by ELISA or radioimmunoassay. Body composition was assessed by dual energy X-ray absorptiometry. Visual analog scales were used to assess hunger and satiety. Results In contrast to lean subjects (p < 0.05), PWS and obese subjects were similarly insulin resistant and had similar insulin levels. Ghrelin[total] levels were significantly higher in PWS compared to obese subjects before and during the meal (p < 0.05). PYY meal responses were higher in PWS than in lean subjects (p = 0.01), but not significantly different to obese (p = 0.08), with an additional non-significant trend in PYY[total] levels. There were no significant differences in self-reported satiety between groups, however PWS subjects reported more hunger throughout (p = 0.003), and exhibited a markedly reduced mealinduced suppression of hunger (p = 0.01) compared to lean or obese subjects. Conclusions Compared to adiposity-matched control subjects, hyperphagia in PWS is not related to a lower postprandial GLP-1 or PYY response. Elevated ghrelin levels in PWS are consistent with increased hunger and are unrelated to insulin levels.

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“…Moreover, the DEXA technique used in this study has been shown to have a strong correlation with insulin resistance. 14 Changes in lean tissue mass in the legs were not significant, but a trend was apparent in that the HIIE group gained, whereas the SSE and CONT lost lean tissue. In the HIIE group, there was also a significant increase in abdominal fat-free mass, suggesting that the trunk musculature was recruited during HIIE.…”

Section: Discussionmentioning

confidence: 88%

The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women

et al. 2008

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Objective: To determine the effects of a 15-week high-intensity intermittent exercise (HIIE) program on subcutaneous and trunk fat and insulin resistance of young women. Design and procedures: Subjects were randomly assigned to one of the three groups: HIIE (n ¼ 15), steady-state exercise (SSE; n ¼ 15) or control (CONT; n ¼ 15). HIIE and SSE groups underwent a 15-week exercise intervention. Subjects: Forty-five women with a mean BMI of 23.2 ± 2.0 kg m À2 and age of 20.2 ± 2.0 years. Results: Both exercise groups demonstrated a significant improvement (Po0.05) in cardiovascular fitness. However, only the HIIE group had a significant reduction in total body mass (TBM), fat mass (FM), trunk fat and fasting plasma insulin levels. There was significant fat loss (Po0.05) in legs compared to arms in the HIIE group only. Lean compared to overweight women lost less fat after HIIE. Decreases in leptin concentrations were negatively correlated with increases in VO 2peak (r ¼ À0.57, Po0.05) and positively correlated with decreases in TBM (r ¼ 0.47; Po0.0001). There was no significant change in adiponectin levels after training. Conclusions: HIIE three times per week for 15 weeks compared to the same frequency of SSE exercise was associated with significant reductions in total body fat, subcutaneous leg and trunk fat, and insulin resistance in young women.

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Abdominal fat and insulin resistance in normal and overweight women: Direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM

Cited by 282 publications

References 0 publications

Diminished upregulation of visceral adipose heme oxygenase-1 correlates with waist-to-hip ratio and insulin resistance

Diminished upregulation of visceral adipose heme oxygenase-1 correlates with waist-to-hip ratio and insulin resistance

In adults with Prader–Willi syndrome, elevated ghrelin levels are more consistent with hyperphagia than high PYY and GLP-1 levels

The effects of high-intensity intermittent exercise training on fat loss and fasting insulin levels of young women

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