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Subcutaneous Abdominal Fat and Thigh Muscle Composition Predict Insulin Sensitivity Independently of Visceral Fat
Published on Oct 1, 1997in Diabetes 7.27
· DOI :10.2337/diacare.46.10.1579
Bret H. Goodpaster79
Estimated H-index: 79
(University of Pittsburgh),
F. L. Thaete4
Estimated H-index: 4
(University of Pittsburgh)
+ 1 AuthorsDavid E. Kelley76
Estimated H-index: 76
(University of Pittsburgh)
Whether visceral adipose tissue has a uniquely powerful association with insulin resistance or whether subcutaneous abdominal fat shares this link has generated controversy in the area of body composition and insulin sensitivity. An additional issue is the potential role of fat deposition within skeletal muscle and the relationship with insulin resistance. To address these matters, the current study was undertaken to measure body composition, aerobic fitness, and insulin sensitivity within a cohort of sedentary healthy men ( n = 26) and women ( n = 28). The subjects, who ranged from lean to obese (BMI 19.6-41.0 kg/m2), underwent dual energy X-ray absorptiometry (DEXA) to measure fat-free mass (FFM) and fat mass (FM), computed tomography to measure cross-sectional abdominal subcutaneous and visceral adipose tissue, and computed tomography (CT) of mid-thigh to measure muscle cross-sectional area, muscle attenuation, and subcutaneous fat. Insulin sensitivity was measured using the glucose clamp technique (40 mU · m∼2 · min−1), in conjunction with [3-3H]glucose isotope dilution. Maximal aerobic power (Vo2max) was determined using an incremental cycling test. Insulin-stimulated glucose disposal ( R d) ranged from 3.03 to 16.83 mg · min−1· kg−1 FFM. R d was negatively correlated with FM ( r = -0.58), visceral fat ( r = -0.52), subcutaneous abdominal fat ( r = -0.61), and thigh fat ( r = -0.38) and positively correlated with muscle attenuation ( r = 0.48) and Vo2max ( r = 0.26, P < 0.05). In addition to manifesting the strongest simple correlation with insulin sensitivity, in stepwise multiple regression, subcutaneous abdominal fat retained significance after adjusting for visceral fat, while the converse was not found. Muscle attenuation contributed independent significance to multiple regression models of body composition and insulin sensitivity, and in analysis of obese subjects, muscle attenuation was the strongest single correlate of insulin resistance. In summary, as a component of central adiposity, subcutaneous abdominal fat has as strong an association with insulin resistance as visceral fat, and altered muscle composition, suggestive of increased fat content, is an important independent marker of insulin resistance in obesity.
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Published on Jul 1, 2002in International Journal of Obesity 5.16
Park Yw1
Estimated H-index: 1
Steven B. Heymsfield62
Estimated H-index: 62
Dympna Gallagher61
Estimated H-index: 61
Are dual-energy X-ray absorptiometry regional estimates associated with visceral adipose tissue mass?
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José Alfredo Martínez Hernández1
Estimated H-index: 1
A. Solomon1
Estimated H-index: 1
Paul Cordero1
Estimated H-index: 1
La obesidad, una enfermedad con creciente prevalencia, se genera por un desequilibrio energetico que podria relacionarse, en algunos casos, con la efi ciencia de la maquinaria energetica celular en la que participan las mitocondrias. Estos organulos son responsables del proceso de fosforilacion oxidativa, que concluye con la transformacion de nutrientes en energia y ATP, generando radicales libres de alto poder oxidativo. Durante este proceso, estos agentes prooxidantes pueden ocasionar dano cel...
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Published on Jan 1, 2006
Frederico G.S. Toledo26
Estimated H-index: 26
(University of Pittsburgh),
David E. Kelley76
Estimated H-index: 76
(University of Pittsburgh)
The ectopic fat theory has gained a significant body of supporting experimental data in the last few years. Yet, much investigational work remains to be done to precisely elucidate the mechanisms by which ectopic fat produce the downstream abnormalities of insulin resistance, hyperglycemia, atherogenic dyslipidemia, and hypertension observed in the metabolic syndrome. Such knowledge is needed not just to further validate the ectopic fat theory, but also to facilitate the design of pharmacologica...
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Published on Jan 1, 2008
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Visceral adiposity is related to development of metabolic syndrome and cardiovascular diseases. We evaluated the relationship between the amount and distribution of abdominal adipose tissue with development of abdominal aortic aneurysm and atherosclerotic changes of the aorta. Total, visceral and subcutaneous abdominal fat areas were measured on a single axial CT scan at the level of umbilicus in 94 patients with abdominal aortic aneurysm and in 94 control subjects. We found no relationship betw...
Published on Jun 21, 2011in Journal of the American College of Cardiology 16.83
Harold E. Bays52
Estimated H-index: 52
Being overweight or obese is a worldwide epidemic. Adiposity can cause fat mass–related cardiovascular disease (CVD). Adiposity may also cause adipocyte and adipose tissue anatomic and functional abnormalities, termed adiposopathy (adipose-opathy) or “sick fat,” that result in endocrine and immune derangements. Adiposopathy may directly contribute to CVD through pericardiac and perivascular effects on the myocardium and blood vessels. Adiposopathy may also indirectly contribute to CVD through pr...
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Published on Mar 1, 2007in Indian Journal of Medical Research 1.51
Nicola Abate33
Estimated H-index: 33
(University of Texas Southwestern Medical Center),
Manisha Chandalia31
Estimated H-index: 31
(University of Texas Southwestern Medical Center)
The rapid increase of diabetes prevalence in the US population and across all westernized world has been associated with environmental changes that promote obesity. However, studies conducted in various ethnic groups within the US population have pointed out differences in susceptibility to diabetes within the same environmental pressure. Of particular interest is the growing evidence that Asian Indians, i.e., persons originating from the Indian Subcontinent, are at uniquely heightened risk for ...
66 Citations
Published on Jan 1, 2009
Insulin resistance (IR) is well documented in type 1 diabetes (T1D) and is theorized to relate to diabetes complications, including renal and coronary artery disease (CAD). The hyperinsulinemic-euglycemic clamp technique provides accurate assessment of IR, yet the laborious, costly, and invasive nature of this technique is often inappropriate for large investigations. Increasing use of the Estimated Glucose Disposal (eGDR) equation in T1D makes further examination of this equation desirable as i...
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