Lower-body fat mass as an independent marker of insulin sensitivity—the role of adiponectin

Abstract

AIMS:To study the association between lower-body fat and estimates of whole-body insulin sensitivity in middle-aged men with and without a history of juvenile onset obesity, and to determine the possible mediating role of fasting serum adiponectin level as an insulin-sensitizing peptide. METHODS: A total of 401 men aged 39-65 y, body mass index 18-54 kg/m 2 , participated in the study. The following variables were measured on the study participants: regional body fat distribution as assessed by dual energy X-ray absorptiometry, abdominal sagittal diameter, maximal oxygen uptake (VO 2 max), physical activity, fasting and post-glucose load levels of plasma glucose, serum insulin, and blood non-esterified fatty acid plus fasting levels of serum adiponectin and HbA1c. RESULTS: Lower-body fat mass was positively associated with insulin sensitivity as estimated by Matsudas index also after adjusting for age, lean tissue mass, trunkal fat mass, weight changes since draft board examination, VO 2 max and the level of physical activity. In a subgroup of men selected for a large lower-body fat mass, fasting serum insulin concentration was 24% lower (Po0.01) and fasting serum adiponectin 33% higher (Po0.005) compared to a subgroup of men with a small lower-body fat mass but with similar trunkal fat mass. CONCLUSION: Lower-body fat mass is positively associated with an estimate of insulin sensitivity independently of trunkal fat mass in both lean and obese middle-aged men and this effect could partly be statistically explained by variations in serum adiponectin levels.

Gluteofemoral body fat as a determinant of metabolic health

“…92 Moreover, higher gluteofemoral fat mass results in higher adiponectin levels and increased insulin sensitivity. 16,93 There is a negative association between adiponectin and waist-to-hip ratio, central fat mass accumulation and visceral fat mass. 6,88,[94][95][96][97] Further, in vitro studies have shown that adiponectin protein content and mRNA expression are lower in visceral adipocytes 98 and that with increasing visceral fat mass adiponectin secretion from those cells is decreased, whereas secretion rates from subcutaneous adipocytes remain unaffected.…”

Sujets « métaboliquement sains », bien qu’obèses. Première partie: diagnostic, physiopathologie et prévalence

“…Une accumulation de graisse périphérique, caractérisée par un rapport tour de taille/tour de hanches abaissé, est associée à un taux plasmatique élevé d'adiponectine, à une bonne sensibilité à l'insuline et à un profil lipidique plus favorable (taux de cholestérol total et de triglycérides plus bas et taux de cholestérol HDL plus élevé) [46]. La graisse glutéofémorale aurait donc un rôle cardioprotecteur [27].…”

“…Cette hormone adipocytaire augmente la sensibilité à l'insuline du foie et des muscles striés squelettiques [48]. Les sujets obèses sensibles à l'insuline ont des taux d'adiponectine significa-tivement plus élevés que les sujets obèses résistants à l'insuline, indépendamment de l'IMC et du tour de taille [46,49]. Les taux d'adiponectine sont plus élevés chez les MHO caractérisés par une meilleure sensibilité à l'insuline [12,46].…”

“…Les sujets obèses sensibles à l'insuline ont des taux d'adiponectine significa-tivement plus élevés que les sujets obèses résistants à l'insuline, indépendamment de l'IMC et du tour de taille [46,49]. Les taux d'adiponectine sont plus élevés chez les MHO caractérisés par une meilleure sensibilité à l'insuline [12,46]. De plus, il a été rapporté récemment que certains sujets obèses ont des taux d'adiponectine comparables à ceux de sujets de poids normal, et ce sont précisément eux qui présentent le phénotype MHO [32].…”

Circulating adiponectin levels are associated with peak oxygen uptake in Japanese

“…Lower circulating adiponectin levels compared to normal controls have been observed in human subjects with obesity, type 2 diabetes mellitus and/ or cardiovascular diseases in some reports [2][3][4]. In the absence of pharmacological agents, increases in circulating adiponectin levels are associated with a decrease in body weight [5,6], a reduction in lower body fat [7] and improved insulin sensitivity [8].…”