Visceral adiposity and risk of type 2 diabetes - A prospective study among Japanese Americans
Visceral adiposity and risk of type 2 diabetes - A prospective study among Japanese Americans
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DOI：
10.2337/diacare.23.4.465
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发表时间：
2000-04-01
期刊：
影响因子：
16.2
通讯作者：
Newell-Morris, L
中科院分区：
文献类型：
--
作者：
Boyko, EJ;Fujimoto, WY;Newell-Morris, L
目的-我们在日裔美国人中进行了一项关于糖尿病发病率与内脏和局部肥胖、空腹胰岛素和C肽以及胰岛素分泌测量的前瞻性研究，因为这些相关性的前瞻性数据很少。空腹过夜后和口服75克葡萄糖耐量试验后30和120分钟测量胰岛素;通过计算机断层扫描（CT）测量腹部、胸部和大腿脂肪面积; BMI（kg/m2）;结果-研究对象包括290名第二代（nisei）和230名第三代（sansei）没有糖尿病的日裔美国人，其中分别有65名和13名发展为糖尿病。在nisei中，连续变量增加1 SD的糖尿病风险的重要预测因子包括腹内脂肪面积（IAFA）（比值比，95% CI）（1.6，1.1-2.3），空腹血浆C肽（1.4，1.1-1.8），和IIR（0.5，0.3-0.9），在调整年龄、性别、糖耐量受损、家族糖尿病史和CT测量的除腹内以外的脂肪区域之后。即使在校正BMI、全身脂肪面积和皮下脂肪面积后，腹内脂肪面积仍然是糖尿病发病率的重要预测因素，尽管没有测量区域或总肥胖与糖尿病的发生相关。在三清人群中，所有的肥胖指标都与糖尿病发病率相关，但是，在调整后的模型中，只有IAFA与更高的风险显著相关。（2.7，1.4-5.4，BMI调整）。结论--在日裔美国人中，更大的内脏肥胖先于2型糖尿病的发展，并证明了与空腹胰岛素、胰岛素分泌、BMI、总体和局部肥胖无关的效应，和糖尿病家族史。
OBJECTIVE - We conducted a prospective study among Japanese Americans of diabetes incidence in relation to visceral and regional adiposity, fasting insulin and C-peptide, and a measure of insulin secretion, because little prospective data exist on these associations.RESEARCH DESIGN AND METHODS - Baseline variables included plasma glucose, C-peptide, and insulin measured after an overnight fast and 30 and 120 min after a 75-g oral glucose tolerance test; abdominal, thoracic, and thigh fat areas by computed tomography (CT); BMI (kg/m(2)); and insulin secretion (incremental insulin response [IIR]).RESULTS - Study subjects included 290 second-generation (nisei) and 230 third-generation (sansei) Japanese Americans without diabetes, of whom 65 and 13, respectively, developed diabetes. Among nisei, significant predictors of diabetes risk for a 1 SD increase in continuous variables included intra-abdominal fat area (IAFA) (odds ratio, 95% CI) (1.6, 1.1-2.3), fasting plasma C-peptide (1.4, 1.1-1.8), and the IIR (0.5, 0.3-0.9) after adjusting for age, sex, impaired glucose tolerance, family diabetes history, and CT-measured fat areas other than intraabdominal. Intra-abdominal fat area remained a significant predictor of diabetes incidence even after adjustment for BMI, total body fat area, and subcutaneous fat area, although no measure of regional or total adiposity was related to development of diabetes. Among sansei, all adiposity measures were related to diabetes incidence, but, in adjusted models, only IAFA remained significantly associated with higher risk (2.7, 1.4-5.4, BMI-adjusted).CONCLUSIONS - Greater visceral adiposity precedes the development of type 2 diabetes in Japanese Americans and demonstrates an effect independent of fasting insulin, insulin secretion, glycemia, total and regional adiposity, and family history of diabetes.