Visceral & subcutaneous abdominal fat in relation to insulin resistance & metabolic syndrome in non-diabetic south Indians.

BACKGROUND & OBJECTIVES The objective of the study was to determine whether visceral or subcutaneous component of abdominal fat was associated with insulin resistance and metabolic syndrome in non- diabetic Asian Indians. METHODS This cross-sectional study had on 120 individuals with normal glucose tolerance (49 males and 71 females). A single slice CT scan at L4- L5 was done for measurement of visceral and subcutaneous abdominal fat. Metabolic syndrome was defined according to the South Asian Modified National Cholesterol Education Program Adult Treatment Panel III criteria (SAM-NCEP) criteria. Insulin Sensitivity Index (ISI-Matsuda) was used to assess insulin sensitivity/resistance. RESULTS Linear regression analysis revealed that visceral, but not subcutaneous fat was associated with serum triglycerides (R(2);=0.457,beta= 0.34; P=0.006), HDL cholesterol (R(2);=0.430, beta= -0.051; P=0.018) and ISI-Matsuda (R(2);=0.437, beta= -0.05; P=0.039) after adjusting for age, gender and BMI. Visceral fat showed significant association with metabolic syndrome (OR: 1.013, 95% CI: 1.001- 1.025; P=0.041) even after adjusting for age, gender, body mass index and glycated haemoglobin whereas subcutaneous fat did not show such an association. INTERPRETATION & CONCLUSION These results indicate that in non-diabetic Asian Indians, visceral, but not subcutaneous component of abdominal fat is associated with insulin resistance, cardiovascular risk factors and metabolic syndrome.

[1]  S. Kahn,et al.  Visceral Adiposity, Not Abdominal Subcutaneous Fat Area, Is Associated With an Increase in Future Insulin Resistance in Japanese Americans , 2008, Diabetes.

[2]  A. Shirahata,et al.  Plasma Visfatin Concentration as a Surrogate Marker for Visceral Fat Accumulation in Obese Children , 2008, Obesity.

[3]  Viswanathan Mohan,et al.  Type 2 Diabetes in South Asians: Epidemiology, Risk Factors and Prevention , 2007 .

[4]  M. Deepa,et al.  The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. , 2007, Journal of the cardiometabolic syndrome.

[5]  Amalia Gastaldelli,et al.  Relationship between hepatic/visceral fat and hepatic insulin resistance in nondiabetic and type 2 diabetic subjects. , 2007, Gastroenterology.

[6]  Udo Hoffmann,et al.  Abdominal Visceral and Subcutaneous Adipose Tissue Compartments: Association With Metabolic Risk Factors in the Framingham Heart Study , 2007, Circulation.

[7]  V. Mohan,et al.  Serum visfatin in relation to visceral fat, obesity, and type 2 diabetes mellitus in Asian Indians. , 2007, Metabolism: clinical and experimental.

[8]  S. Kahn,et al.  Intra-abdominal fat accumulation predicts the development of the metabolic syndrome in non-diabetic Japanese-Americans , 2007, Diabetologia.

[9]  V. Mohan,et al.  Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES‐34) , 2007, Diabetes/metabolism research and reviews.

[10]  A. Shuldiner,et al.  Identification of omentin as a novel depot-specific adipokine in human adipose tissue: possible role in modulating insulin action. , 2006, American journal of physiology. Endocrinology and metabolism.

[11]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[12]  H. S. Park,et al.  Greater beneficial effects of visceral fat reduction compared with subcutaneous fat reduction on parameters of the metabolic syndrome: a study of weight reduction programmes in subjects with visceral and subcutaneous obesity , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[13]  V. Mohan,et al.  Visceral and central abdominal fat and anthropometry in relation to diabetes in Asian Indians. , 2004, Diabetes care.

[14]  Jane B Shofer,et al.  Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. , 2004, Diabetes.

[15]  V. Mohan,et al.  The Chennai Urban Rural Epidemiology Study (CURES)--study design and methodology (urban component) (CURES-I). , 2003, The Journal of the Association of Physicians of India.

[16]  S. Joshi.  Metabolic syndrome--emerging clusters of the Indian phenotype. , 2003, The Journal of the Association of Physicians of India.

[17]  D. Simonson,et al.  Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. , 2001, The Journal of clinical endocrinology and metabolism.

[18]  S. O’Rahilly,et al.  The perils of portliness: causes and consequences of visceral adiposity. , 2000, Diabetes.

[19]  M. Matsuda,et al.  Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. , 1999, Diabetes care.

[20]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[21]  B. Goodpaster,et al.  Subcutaneous Abdominal Fat and Thigh Muscle Composition Predict Insulin Sensitivity Independently of Visceral Fat , 1997, Diabetes.

[22]  S. Grundy,et al.  Relationships of generalized and regional adiposity to insulin sensitivity in men. , 1995, The Journal of clinical investigation.

[23]  P. Arner,et al.  Mechanisms for differences in lipolysis between human subcutaneous and omental fat cells. , 1992, The Journal of clinical endocrinology and metabolism.

[24]  A Tremblay,et al.  Visceral Obesity in Men: Associations With Glucose Tolerance, Plasma Insulin, and Lipoprotein Levels , 1992, Diabetes.

[25]  Y. Matsuzawa,et al.  Improvement of glucose and lipid metabolism associated with selective reduction of intra-abdominal visceral fat in premenopausal women with visceral fat obesity. , 1991, International journal of obesity.

[26]  P. Björntorp,et al.  Metabolism of adipose tissue in intraabdominal depots of nonobese men and women. , 1989, Metabolism: clinical and experimental.

[27]  J. Levy,et al.  Insulin Resistance in Patients of Asian Indian and European Origin with Non-Insulin Dependent Diabetes , 1987, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[28]  R. Turner,et al.  Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man , 1985, Diabetologia.

[29]  A. Kissebah,et al.  Relation of Body Fat Distribution to Metabolic Complications of Obesity , 1982 .

[30]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[31]  V. Mohan,et al.  Abdominal obesity, visceral fat and type 2 diabetes - "Asian Indian phenotype". , 2007 .

[32]  H. Lebovitz,et al.  Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. , 1999, The Journal of clinical endocrinology and metabolism.

[33]  W. Kannel,et al.  Regional obesity and risk of cardiovascular disease; the Framingham Study. , 1991, Journal of clinical epidemiology.

[34]  F. Terry.  Human obesity. , 1987, Annals of the New York Academy of Sciences.

[35]  Y. Matsuzawa,et al.  Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. , 1987, Metabolism: clinical and experimental.