Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans
Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans
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DOI：
10.2337/db07-1378
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发表时间：
2008-05-01
期刊：
影响因子：
7.7
通讯作者：
Fujimoto, Wilfred Y.
中科院分区：
文献类型：
--
作者：
Hayashi, Tomoshige;Boyko, Edward J.;Fujimoto, Wilfred Y.
内脏肥胖通常被认为在代谢综合征中起关键作用。我们试图确定是否更大的内脏脂肪直接测量计算机断层扫描（CT）与增加未来的胰岛素抵抗独立于其他脂肪depots.Research设计和方法，我们遵循了306非糖尿病日裔美国人超过10-11年。基线变量包括BMI;腰围;以及通过CT测量的腹部、胸部和大腿脂肪面积。通过所有这些脂肪面积的总和估计总脂肪面积。内脏性肥胖测量为脐水平的腹内脂肪面积。总皮下脂肪面积定义为总脂肪面积减去腹内脂肪面积。采用胰岛素抵抗稳态模型（HOMA-IR）、空腹血浆胰岛素水平、松田指数、和胰岛素的口服葡萄糖耐量试验曲线下面积（AUC）。（P = 0.002）和HOMA-IR（P < 0.001）与HOMA-IR增加独立相关，在校正腹部皮下脂肪面积、年龄、性别、2小时血糖水平和递增胰岛素反应后，多元线性回归模型中的11年。即使在校正了总皮下脂肪面积、总脂肪面积、BMI或腰围后，腹内脂肪面积仍然是10-11年时HOMA-IR增加的重要预测因素，但在包含腹内脂肪面积的模型中，CT测量的区域或总肥胖度的其他指标与10-11年时HOMA-IR无显著相关性。预测未来的空腹血浆胰岛素水平，松田指数，和AUC insulin.CONCLUSIONS-Greater内脏肥胖与未来胰岛素抵抗的增加。
OBJECTIVE-Visceral adiposity is generally considered to play a key role in the metabolic syndrome. We sought to determine whether greater visceral adiposity directly measured by computed tomography (CT) is associated with increased future insulin resistance independent of other adipose depots.RESEARCH DESIGN AND METHODS-We followed 306 nondiabetic Japanese Americans over 10-11 years. Baseline variables included BMI; waist circumference; and abdominal thoracic, and thigh fat areas measured by CT. Total fat area was estimated by the sum of all of these fat areas. Visceral adiposity was measured as intra-abdominal fat area at the umbilicus level. Total subcutaneous fat area was defined as total fat area minus intra-abdominal fat area. Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), fasting plasma insulin level, Matsuda index, and area under the oral glucose tolerance test curve (AUC) of insulin.RESULTS-Both baseline intra-abdominal fat area (P = 0.002) and HOMA-IR (P < 0.001) were independently associated with increased HOMA-IR at 10-11 years in a multiple linear regression model after adjustment for abdominal subcutaneous fat area, age, sex, 2-h plasma glucose level, and incremental insulin response. Intra-abdominal fat area remained a significant predictor of increased HOMA-IR at 10-11 years even after adjustment for total subcutaneous fat area, total fat area, BMI, or waist circumference, but no other measure of CT-measured regional or total adiposity was significantly related with HOMA-IR at 10-11 years in models that contained intra-abdominal fat area. Similar results were obtained for predicting future fasting plasma insulin level, Matsuda index, and AUC of insulin.CONCLUSIONS-Greater visceral adiposity is associated with an increase in future insulin resistance.