Relationships of generalized and regional adiposity to insulin sensitivity in men.

Abate, Nicola; Garg, Abhimanyu; Peshock, Ronald M; Stray-Gundersen, J.; Grundy, Scott M.

doi:10.1172/jci118083

Cited by 682 publications

(469 citation statements)

References 67 publications

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“…Asian Indians have been shown to be more insulin-resistant than most other ethnic groups [27]. Preferential deposition and distribution of fat in the abdominal region is associated with reduced insulin-mediated glucose disposal, independent of an overall degree of obesity [28,29,30]. Anthropometric studies have shown that the distribution of fat differs between ethnic groups, and thus identical distributions of BMI in two populations could still reflect large differences with respect to the accumulation of intraabdominal fat, and Asian populations have been shown to be more prone to abdominal obesity and low muscle mass [27,31,32,33].…”

Section: Discussionmentioning

confidence: 99%

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

Group

2003

Diabetologia

174

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Aims/hypothesis. The aim of this study was to assess the effect of ethnicity on the association between age and body mass index as well as the prevalence of diabetes. Methods. We selected population-based studies carried out after 1980 in the DECODE/A studies representing different ethnic groups: 11 European, 1 Maltese, 3 Indian, 2 Chinese and 3 Japanese surveys. The total numbers of subjects were 14,240 men and 15,129 women who were 30 to 89 years of age. Diabetes was diagnosed according to the 1999 World Health Organization criteria based on a standard 75 g OGTT. Sexspecific prevalence of diabetes by age and BMI was stratified by ethnic group, in particular the interaction of ethnicity on the associations between age/BMI and the prevalence of diabetes.Results. The prevalence of diabetes was higher in studies from India and Malta compared to Japan, China, and the rest of Europe. The association between BMI and diabetes, adjusted for age, showed noticeable differences between the ethnic groups with an increase in prevalence starting at a BMI between 15 and 20 kg/m 2 in the Maltese and Indian populations compared to 25 kg/m 2 in Europeans. Conclusion/interpretation. The effect of BMI on the age-adjusted prevalence of Type 2 diabetes was modified by ethnicity with considerably lower thresholds in Indian and Maltese subjects compared to those from the rest of Europe. This difference should be reflected in national and international recommendations regarding "optimal" BMI.

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Section: Discussionmentioning

confidence: 99%

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

Group

2003

Diabetologia

174

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“…Moreover, intra-abdominal fat has been found to be a better determinant of insulin resistance than subcutaneous abdominal fat in most 1 but not all 2,3 studies. Subcutaneous abdominal fat may be divided into superficial and deep compartments that have different morphologies where only the deep compartment may produce insulin resistance.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2005

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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.

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“…Abdominal obesity is known to be an important factor in determining insulin resistance and an adverse lipid profile. [18][19][20] There is evidence that intraabdominal fat, in particular, is associated with insulin resistance. 21 The women in this study were mainly perimenopausal; only a small number had early menopause.…”

Section: Discussionmentioning

confidence: 99%

Lifecourse predictors of normal metabolic parameters in overweight and obese adults

2006

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Objective: Not all overweight and obese individuals appear to be at equal risk of developing metabolic abnormalities. We sought to examine the effect of factors from different stages of life on risk of metabolic abnormalities at age 50 years in overweight and obese adults. Design and subjects: Longitudinal study of all persons born in Newcastle upon Tyne, UK in May and June 1947 and followed to age 50 years when a clinical examination took place and a detailed questionnaire on health and lifestyle was completed. Participants in this study (n ¼ 223) were those defined as being overweight or obese with a body mass index (BMI) greater than or equal to 25 at age 50 years. Subjects were defined as 'metabolically normal' if they had normal lipids, glucose and blood pressure. Results: Lower BMI was the strongest predictor of remaining metabolically normal in both men and women. After adjusting for BMI, lower levels of cigarette smoking and higher levels of physical activity were independently associated with being metabolically normal in men. No other factors were independently associated with being metabolically normal in women. A stronger inverse relationship between BMI and metabolic status was found in men (Odds ratio (OR) per unit increase in BMI ¼ 0.65, 95% confidence intervals (95% CI) 0.52-0.81) than in women (OR ¼ 0.90, 95% CI 0.82-0.99). No association was seen for factors operating in fetal, infant and childhood life. Conclusions: Adult factors made a greater contribution to remaining metabolically normal than birth or childhood factors in this sample of overweight and obese adults. A lower adult BMI appeared to reduce the risk in men and women and lower cigarette smoking and higher level of physical activity also independently reduced the risk in men. Public health policy to reduce the burden of morbidity associated with obesity should continue to encourage weight loss, physical activity and smoking cessation.

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Relationships of generalized and regional adiposity to insulin sensitivity in men.

Cited by 682 publications

References 67 publications

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

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

Lifecourse predictors of normal metabolic parameters in overweight and obese adults

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