Subscribe to RSS
DOI: 10.1055/s-2006-923886
J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Visceral Adipose Tissue as an Indicator of Insulin Resistance in Nonobese Patients with New Onset Type 2 Diabetes Mellitus
Publication History
Received: January 18, 2005
First decision: April 13, 2005
Accepted: November 24, 2005
Publication Date:
29 March 2006 (online)
![](https://www.thieme-connect.de/media/eced/200602/lookinside/thumbnails/10.1055-s-2006-923886-1.jpg)
Abstract
Background: Obesity and type 2 diabetes mellitus are characterized by insulin resistance. We determined the relationship between insulin resistance and visceral adipose tissue (VAT) and their correlation with bioimpedance analysis in nonobese new onset type 2 diabetes patients. Methods: A number of 30 new onset type 2 diabetes patients and 20 healthy control subjects with similar features, age between 45 - 72 years old, BMI < 27 kg/m2, C-peptide > 0.6 nmol/L, were included in study. Fasting blood glucose, HbA1c, serum lipids, BMI, insulin, C-peptide, HOMA‐IR, bioimpedance analysis and visceral and subcutaneous adipose tissue (by computed tomography) were measured. Results: In the patient group, VAT was significantly higher compared to healthy control group (33.17 ± 10.23 % vs. 16.53 ± 7.85 %, p < 0.001). In the patient group VAT was correlated with HOMA‐IR (r = 0.62, p = 0.003), but no significant correlation was observed between VAT and bioimpedance analysis. Conclusions: The amount of VAT is significantly higher in nonobese new onset patients with type 2 diabetes than the healthy control group. In these patients, VAT measured by CT is an important indicator of insulin resistance. Although bioimpedance analysis can give an idea about total body fat and obesity, it is not sufficient in evaluating fat distribution and therefore is not effective in predicting insulin resistance.
Key words
Visceral adiposity - new onset nonobese type 2 diabetes - insulin resistance
References
- 1 Abate N, Garg A, Peshock R, Stray-Gundersen J, Adama-Huet B, Grundy S. Relationship of generalized and regional adiposity to insulin sensitivity in men with NIDDM. Diabetes. 1996; 45 1684-1693
- 2 Abate N, Garg A, Peshock R, Stray-Gundersen J, Grundy S. Relationship of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest. 1995; 96 88-98
- 3 Altuntas Y, Bilir M, Ozturk B, Gundogdu S. Comparison of various simple insulin sensitivity and beta-cell function indices in lean hyperandrogenemic and normoandrogenemic young hirsute women. Fertil Steril. 2003; 80 133-142
- 4 Björntorp P. “Portal” adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis. 1990; 10 493-496
- 5 Bonora E, Del Prato S, Bonadonna R C. et al . Total body fat content and fat topography are associated differently with in vivo glucose metabolism in obese and nonobese nondiabetic women. Diabetes. 1992; 41 1151-1159
- 6 Brochu M, Starling R D, Tchernof A, Matthews D, Garcia-Rubi E, Poehlman E T. Visceral adipose tissue is an independent correlate of glucose disposal in older obese postmenopausal women. J Clin Endocrinol Metab. 2000; 85 2378-2384
- 7 Carey D G, Jenkins A B, Campbell L V, Freund J, Chisholm D J. Abdominal fat and insulin resistance in normal and overweight women. Diabetes. 1996; 45 633-638
- 8 DeNino W F, Tchernof A, Dionne I J, Toth M J, Ades P A, Sites C K, Poehlman E T. Contribution of abdominal adiposity to age-related differences in insulin sensitivity and plasma lipid in healthy nonobese women. Diabetes Care. 2001; 24 925-932
- 9 Despres J P, Nadeau A, Tremblay A. et al . Role of deep abdominal fat in the association between regional adipose tissue distribution and glucose tolerance in obese women. Diabetes. 1989; 38 304-309
- 10 Garcia-Estevez D A, Araujo-Vilar D, Saavedra-Gonzalez A, Fiestras-Janeiro G, Cabezas-Cerrato J. Glucose metabolism in lean patients with mild type 2 diabetes mellitus: evidence for insulin-resistant variants. Metabolism. 2002; 51 1047-1052
- 11 Goodpaster B H, Thaete F L, Simoneau J ‐A, Kelley D E. Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat. Diabetes. 1997; 46 1579-1585
- 12 Kahn S E, Prigeon R L, McCulloch D K, Boyko E J, Bergman R N, Schwartz M W, Neifing J L, Ward W K, Beard J C, Palmer J P, Porte D. Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function. Diabetes. 1993; 42 1663-1672
- 13 Kahn S E, Prigeon R L, Schwartz R S. et al . Obesity, body fat distribution, insulin sensitivity and islet β-cell function as explanations for metabolic diversity. J Nutr. 2001; 131 354-360
- 14 Kelley D E, Tahaete E L, Troost F, Huwe T, Goodpaster B H. Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance. Am J Physiol Endocrinol Metab. 2000; 278 E941-E948
- 15 Kvist H, Chowdhury B, Grangard U, Tylen U, Sjoström L. Total and visceral adipose tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. Am J Clin Nutr. 1998; 48 1351-1361
- 16 Pouliot M C, Despres J P, Nadeau A. et al . Visceral obesity in men: associations with glucose tolerance, plasma insulin and lipoprotein levels. Diabetes. 1992; 41 826-834
- 17 Randle P, Hales C, Garland P, Newsholme E. The glucose fatty acid cycle. Lancet. 1963; 1 785-789
- 18 Ross R, Dagnone D, Jones P, Smith H, Paddags A, Hudson R, Janssen I. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. Ann Intern Med. 2000; 122 99-103
- 19 Ross R, Fortier L, Hudson R. Separate associations between visceral and subcutaneous adipose tissue distribution, insulin and glucose levels in obese women. Diabetes Care. 1996; 19 1404-1411
- 20 Ross R, Freeman J, Hudson R, Janssen I. Abdominal obesity, muscle composition, and insulin resistance in premenopausal women. J Clin Endocrinol Metab. 2002; 87 5044-5051
- 21 Ross R, Shaw K D, Rissanen J, Martel Y, de Guise J, Avruch L. Sex differences in lean and adipose tissue distribution measured by magnetic resonance imaging. Am J Clin Nutr. 1994; 59 1277-1285
- 22 Shulman G I. Cellular mechanisms of insulin resistance. J Clin Invest. 2000; 106 171-176
- 23 Toth M J, Sites C K, Cefalu W T, Matthews D E, Poehlman E T. Determinants of insulin-stimulated glucose disposal in middle-aged, premenopausal women. Am J Physiol Endocrinol Metab. 2001; 281 E113-E121
Okcan Basat
Levazım Mah. Aktas Sitesi G Blok D.5
Levent 34340
Istanbul
Turkey
Phone: +902122758882
Fax: + 90 212 234 46 85
Email: u_74@yahoo.de