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Luo A, Tang Z, Xu X, Li C, Zhou D, Xiao D, Lu Y, Liang R, Guan G, Li W, Hu Z. Cutoffs of different body measurement indexes of central obesity in patients with type 2 diabetes. Sci Rep 2024; 14:2154. [PMID: 38273013 PMCID: PMC10811333 DOI: 10.1038/s41598-024-52645-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 01/22/2024] [Indexed: 01/27/2024] Open
Abstract
Few research discuss whether the body measurement indexs of obesity in general populations is applicable to patients with type 2 diabetes. We explore the optimal cutoffs of visceral fat area (VFA) and subcutaneous fat area (SFA) in the diagnosis of central obesity and the cutoffs of corresponding waist circumference (WC) and body mass index (BMI) in patients with Type 2 Diabetes (T2D). Cross-sectional cohort study. 1057 patients with T2D (550 males and 507 females) aged 18 or above that satisfied the criteria were included. The definition and diagnostic criteria of Metabolic syndrome (Mets) were analyzed according to the 2020 Chinese Diabetes Society (CDS) Guideline. The VFA and SFA were measured by bioelectrical impedance analysis (BIA). The optimal VFA and SFA cutoffs and corresponding WC and BMI when two or more nonadipose components of MetS (without central obesity) were met were analyzed by ROC curve. Among all of the T2D patients, the optimal VFA cutoff for identifying two or more nonadipose components of MetS was 73.30 cm2 for females and 69.20 cm2 for males, while the optimal SFA cutoff was 186.70 cm2 for females and 123.30 cm2 for males. The ROC area under curve (AUC) of VFA for identifying two or more nonadipose components of MetS was higher than that of SFA (Female: 0.65 vs. 0.58, P = 0.01). The VFA cutoff of newly diagnosed T2D patients (females = 86.10 cm2, males = 69.00 cm2) was higher than that of non-newly diagnosed T2D patients (females = 73.30 cm2, males = 65.40 cm2). A stratification analysis of gender and whether newly diagnosed with T2D or not showed that the WCs corresponding to VFA were 85.00 cm and BMI was about 24.00 kg/m2. VFA measured by BIA can be a non-invasive method to detect central obesity in patients with T2D, the corresponding WC were 85.00 cm and BMI was 24.00 kg/m2.
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Affiliation(s)
- Ai Luo
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Zheng Tang
- Guangdong Medical University, Zhanjiang, 524000, China
| | - XiaoJia Xu
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Chao Li
- Guangdong Medical University, Zhanjiang, 524000, China
| | - Die Zhou
- Department of Laboratory, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Dong Xiao
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Yongjie Lu
- School of Public Health, Guangzhou Medical University, Guangzhou, 510220, China
| | - Rutao Liang
- Guangdong Medical University, Zhanjiang, 524000, China
| | - Guifen Guan
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China
| | - Wangen Li
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
| | - Zhuoqing Hu
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510220, China.
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Hu H, Nakagawa T, Honda T, Yamamoto S, Mizoue T. Should insulin resistance (HOMA-IR), insulin secretion (HOMA-β), and visceral fat area be considered for improving the performance of diabetes risk prediction models. BMJ Open Diabetes Res Care 2024; 12:e003680. [PMID: 38191206 PMCID: PMC10806829 DOI: 10.1136/bmjdrc-2023-003680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/19/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Insulin resistance and defects in pancreatic beta cells are the two major pathophysiologic abnormalities that underlie type 2 diabetes. In addition, visceral fat area (VFA) is reported to be a stronger predictor for diabetes than body mass index (BMI). Here, we tested whether the performance of diabetes prediction models could be improved by adding HOMA-IR and HOMA-β and replacing BMI with VFA. RESEARCH DESIGN AND METHODS We developed five prediction models using data from a cohort study (5578 individuals, of whom 94.7% were male, and 943 had incident diabetes). We conducted a baseline model (model 1) including age, sex, BMI, smoking, dyslipidemia, hypertension, and HbA1c. Subsequently, we developed another four models: model 2, predictors in model 1 plus fasting plasma glucose (FPG); model 3, predictors in model 1 plus HOMA-IR and HOMA-β; model 4, predictors in model 1 plus FPG, HOMA-IR, and HOMA-β; model 5, replaced BMI with VFA in model 2. We assessed model discrimination and calibration for the first 10 years of follow-up. RESULTS The addition of FPG to model 1 obviously increased the value of the area under the receiver operating characteristic curve from 0.79 (95% CI 0.78, 0.81) to 0.84 (0.83, 0.85). Compared with model 1, model 2 also significantly improved the risk reclassification and discrimination, with a continuous net reclassification improvement index of 0.61 (0.56, 0.70) and an integrated discrimination improvement index of 0.09 (0.08, 0.10). Adding HOMA-IR and HOMA-β (models 3 and 4) or replacing BMI with VFA (model 5) did not further materially improve the performance. CONCLUSIONS This cohort study, primarily composed of male workers, suggests that a model with BMI, FPG, and HbA1c effectively identifies those at high diabetes risk. However, adding HOMA-IR, HOMA-β, or replacing BMI with VFA does not significantly improve the model. Further studies are needed to confirm our findings.
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Affiliation(s)
- Huan Hu
- Research Center for Prevention from Radiation Hazards of Workers, National Institute of Occupational Safety and Health, Kawasaki, Kanagawa, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd, Hitachi, Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd, Hitachi, Ibaraki, Japan
| | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Heath and Medicine, Tokyo, Japan
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Sahoyama Y, Hamazato F, Shiozawa M, Nakagawa T, Suda W, Ogata Y, Hachiya T, Kawakami E, Hattori M. Multiple nutritional and gut microbial factors associated with allergic rhinitis: the Hitachi Health Study. Sci Rep 2022; 12:3359. [PMID: 35233003 PMCID: PMC8888718 DOI: 10.1038/s41598-022-07398-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022] Open
Abstract
Several studies suggest the involvement of dietary habits and gut microbiome in allergic diseases. However, little is known about the nutritional and gut microbial factors associated with the risk of allergic rhinitis (AR). We recruited 186 participants with symptoms of AR and 106 control subjects without symptoms of AR at the Hitachi Health Care Center, Japan. The habitual consumption of 42 selected nutrients were examined using the brief-type self-administered diet history questionnaire. Faecal samples were collected and subjected to amplicon sequencing of the 16S ribosomal RNA gene hypervariable regions. Association analysis revealed that four nutrients (retinol, vitamin A, cryptoxanthin, and copper) were negatively associated with AR. Among 40 genera examined, relative abundance of Prevotella and Escherichia were associated with AR. Furthermore, significant statistical interactions were observed between retinol and Prevotella. The age- and sex-adjusted odds of AR were 25-fold lower in subjects with high retinol intake and high Prevotella abundance compared to subjects with low retinol intake and low Prevotella abundance. Our data provide insights into complex interplay between dietary nutrients, gut microbiome, and the development of AR.
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Affiliation(s)
- Yukari Sahoyama
- Technology Innovation Div., Hitachi High-Tech Corporation, Business Tower, Toranomon Hills, 1-17-1 Minato-ku, Toranomon, Tokyo, 105-6409, Japan.
| | - Fumiaki Hamazato
- Technology Innovation Div., Hitachi High-Tech Corporation, Business Tower, Toranomon Hills, 1-17-1 Minato-ku, Toranomon, Tokyo, 105-6409, Japan
| | - Manabu Shiozawa
- Technology Innovation Div., Hitachi High-Tech Corporation, Business Tower, Toranomon Hills, 1-17-1 Minato-ku, Toranomon, Tokyo, 105-6409, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi Ltd., Ibaraki, Japan
| | - Wataru Suda
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yusuke Ogata
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - Eiryo Kawakami
- Medical Sciences Innovation Hub Program, RIKEN, Yokohama, Japan.,Artificial Intelligence Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masahira Hattori
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.,Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
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Association between Adipose Tissue Depots and Dyslipidemia: The KORA-MRI Population-Based Study. Nutrients 2022; 14:nu14040797. [PMID: 35215449 PMCID: PMC8879798 DOI: 10.3390/nu14040797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 12/26/2022] Open
Abstract
Obesity increases the risk of cardiovascular diseases (CVD), however, whether adipose tissue relates to dyslipidemia, and consequently to cardiovascular events remains unknown. Thus, we investigated the association of adipose tissue with circulating lipoproteins and triglycerides (TG) in subjects without CVD. 384 participants from the KORA-MRI study (mean age 56.2 ± 9.2 years; 41.9% female) underwent whole-body 3T-MRI. Visceral (VAT) and subcutaneous adipose tissue (SAT) derived from T1-DIXON-sequence using a semi-automatic algorithm. Total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and TG were measured. Linear regression was applied to examine the relationships between adipose tissue, circulating lipoproteins, and TG, adjusting for risk factors. VAT was associated with total cholesterol (per SD increase) (ß = 0.39, p < 0.001). Total adipose tissue (TAT) and VAT were inversely associated with HDL (ß = -0.09, p = 0.009; ß = -0.14, p < 0.001), and positively associated with LDL (ß = 0.32, p < 0.001; ß = 0.37, p < 0.001). All adipose tissues were associated with TG (ß = 0.20, p < 0.001; ß = 0.27, p < 0.001; ß = 0.11, p = 0.004). Stratified analysis by sex and body mass index (BMI) was confirmatory in women and in individuals with BMI < 30. Our results suggest that adipose tissue plays an important role in increasing CVD risk independent of BMI, whereas gender imbalance may be explained by accurate characterization and quantification of adipose tissue.
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Cao L, Zhou J, Chen Y, Wu Y, Wang Y, Liu T, Fu C. Effects of Body Mass Index, Waist Circumference, Waist-to-Height Ratio and Their Changes on Risks of Dyslipidemia among Chinese Adults: The Guizhou Population Health Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010341. [PMID: 35010598 PMCID: PMC8750900 DOI: 10.3390/ijerph19010341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 12/28/2022]
Abstract
This study aimed to assess the effects of different anthropometric indices and their changes on the risk of incident dyslipidemia among the Chinese population. From the Guizhou population health cohort study, 2989 Chinese adults without dyslipidemia at baseline were followed up. Anthropometric parameters including waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), and their changes in the latter two indices, and serum lipids were tested after at least 8 h fasting. Hazard ratio (HR), adjusted hazard ratio (aHR), and 95% confidential interval (CI) were calculated to estimate the association between anthropometric parameters and dyslipidemia risk using multivariate Cox regression. A total of 2089 (69.98%) new dyslipidemia cases were identified over an average follow-up of 7.0 years. Baseline BMI (aHR = 1.12, 95%CI 1.01, 1.23) and WHtR (aHR = 1.06, 95%CI 1.00, 1.13) were positively associated with higher risks of incident dyslipidemia but not WC. Each 5.0 kg/m2 increment of BMI or 0.05-unit increment of WHtR was significantly associated with 43% or 25% increased risk of incident dyslipidemia, respectively. The aHRs (95%CI) of incident dyslipidemia for subjects maintaining or developing general obesity were 2.19 (1.53, 3.12) or 1.46 (1.22, 1.75), and 1.54 (1.23, 1.82) or 1.30 (1.06, 1.60) for subjects maintaining or developing abdominal obesity, respectively. Linear trends for aHRs of BMI, WHtR change, and BMI change were observed (p for trend: 0.021, <0.001, <0.001, respectively). BMI, WHtR, and their changes were closely associated with the incidence of dyslipidemia for Chinese adults. Loss in BMI and WHtR had protective effects on incident dyslipidemia, whereas gain of BMI or WHtR increased the dyslipidemia risk. Interventions to control or reduce BMI and WHtR to the normal range are important for the early prevention of dyslipidemia, especially for participants aged 40 years or above, male participants, and urban residents with poor control of obesity.
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Affiliation(s)
- Li Cao
- Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China; (L.C.); (Y.C.)
| | - Jie Zhou
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (J.Z.); (Y.W.); (Y.W.)
| | - Yun Chen
- Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China; (L.C.); (Y.C.)
| | - Yanli Wu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (J.Z.); (Y.W.); (Y.W.)
| | - Yiying Wang
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (J.Z.); (Y.W.); (Y.W.)
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (J.Z.); (Y.W.); (Y.W.)
- Correspondence: (T.L.); (C.F.)
| | - Chaowei Fu
- Key Laboratory of Public Health Safety & NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai 200032, China; (L.C.); (Y.C.)
- Correspondence: (T.L.); (C.F.)
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Murata Y, Nakamura E, Tsukamoto M, Nakagawa T, Takeda M, Kozuma M, Kadomura T, Narusawa K, Shimizu K, Uchida S, Hayashi T, Sakai A. Longitudinal study of risk factors for decreased cross-sectional area of psoas major and paraspinal muscle in 1849 individuals. Sci Rep 2021; 11:16986. [PMID: 34417520 PMCID: PMC8379148 DOI: 10.1038/s41598-021-96448-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022] Open
Abstract
This 10-year retrospective observational study investigated longitudinal losses in psoas major and paraspinal muscle area in 1849 healthy individuals (1690 male, 159 female) screened using computed tomography. Logistic regression analysis revealed significant decreases in psoas major and paraspinal muscle area at 10 years relative to the baseline area regardless of age or sex, starting at 30 years of age. Only aging [≥ 50 s (odds ratio [OR]: 1.72; 95% confidence interval [CI] 1.05–2.84; p = 0.03) and ≥ 60 s (OR: 2.67; 95% CI 1.55–4.60; p < 0.001)] was a risk factor for decreases in psoas major area. Age ≥ 60 years (OR: 2.05; 95% CI 1.24–3.39; p = 0.005), body mass index ≥ 25 kg/m2 (OR: 1.32; 95% CI 1.01–1.73; p = 0.04), and visceral fat ≥ 100 cm2 (OR: 1.61; 95% CI 1.20–2.15; p = 0.001) were risk factors for decreases in paraspinal muscle area. Physical activity ≥ 900 kcal/week (OR: 0.68; 95% CI 0.50–0.94; p = 0.02) attenuated paraspinal muscle area loss in male. Our study demonstrated that walking > 45 min daily (Calories = METs (walking: 3.0) × duration of time (h) × weight (60 kg) × 1.05) can reduce paraspinal muscle loss, which may in turn decrease the risk of falls, low-back pain, and sarcopenia.
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Affiliation(s)
- Yoichi Murata
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Eiichiro Nakamura
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan.
| | - Manabu Tsukamoto
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Toru Nakagawa
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Masaru Takeda
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Mio Kozuma
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Takayuki Kadomura
- Health Care Business Unit, Hitachi Ltd., 2 Shintoyofuta, Kashiwa, Chiba, 2770804, Japan
| | - Kenichiro Narusawa
- Department of Orthopaedic Surgery, Nakashibetsu Town Hospital, 9-1-1, 10-jo Minami, Nakashibetsu-cho Nishi, Hokkaido, 0861110, Japan
| | - Kenji Shimizu
- Department of Orthopaedic Surgery, Tobata Kyoritsu Hospital, 2-5-1 Sawami, Tobata, Kitakyushu, Fukuoka, 8040093, Japan
| | - Soshi Uchida
- Department of Orthopaedic Surgery and Sports Medicine, Wakamatsu Hospital of University of Occupational and Environmental Health, 1-17-1 Hamamachi, Wakamatsu, Kitakyushu, Fukuoka, 8080024, Japan
| | - Takeshi Hayashi
- Occupational Health Section, Hitachi Health Care Center, Hitachi Ltd., 4-3-16 Osecho, Hitachi, Ibaraki, 3170076, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu, Fukuoka, 8078555, Japan
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Liu B, Fan D, Yin F. The Relationship between Vitamin D Status and Visceral Fat Accumulation in Males with Type 2 Diabetes. J Nutr Sci Vitaminol (Tokyo) 2020; 66:396-401. [PMID: 33132341 DOI: 10.3177/jnsv.66.396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Vitamin D deficiency may play an important role in obesity. The aim of the study was to explore the relationship between vitamin D status and visceral fat accumulation in males with type 2 diabetes. A cross-sectional study was conducted on 128 adult males with type 2 diabetes in Qinhuangdao. The nutritional status of vitamin D was assessed by circulating levels of 25(OH)D, vitamin D deficiency <30 nmol/L, vitamin D insufficiency 30-50 nmol/L and vitamin D sufficiency >50 nmol/L. Accumulation of visceral fat was defined as visceral fat area ≥100 cm2. The prevalence of visceral fat accumulation was 35.9%. The prevalence of visceral fat accumulation was 14.6%, 45.1% and 50.0% in type 2 diabetes with vitamin D sufficiency, vitamin D insufficiency and vitamin D deficiency, respectively. In multiple logistic regression analysis, subjects with vitamin D insufficiency [OR=4.255, p=0.012] and vitamin D deficiency [OR=6.122, p=0.022] were more likely to have visceral fat accumulation compared with subjects with vitamin D sufficiency. Visceral fat accumulation linked to the cluster of cardiometabolic risk factor in males with type 2 diabetes. There was a significant correlation between vitamin D status and visceral fat accumulation in males with type 2 diabetes.
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Affiliation(s)
- Bowei Liu
- Department of Endocrinology, The First Hospital of Qinhuangdao
| | - Dongmei Fan
- Department of Endocrinology, The First Hospital of Qinhuangdao
| | - Fuzai Yin
- Department of Endocrinology, The First Hospital of Qinhuangdao
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Liu AW, Song SO, Hayashi T, Sato KK, Kahn SE, Leonetti DL, Fujimoto WY, Boyko EJ. Change in CT-measured abdominal subcutaneous and visceral but not thigh fat areas predict future insulin sensitivity. Diabetes Res Clin Pract 2019; 154:17-26. [PMID: 31228493 PMCID: PMC6698223 DOI: 10.1016/j.diabres.2019.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 01/07/2023]
Abstract
AIMS We examined the longitudinal association between change in body composition directly measured by computed tomography (CT) and future insulin sensitivity. METHODS This was a prospective study with 10 years of follow-up with 297 Japanese-American without diabetes. Intra-abdominal fat area (IAFA) and abdominal subcutaneous fat area (SCFA), and thigh SCFA were measured by CT. Insulin sensitivity was calculated by HOMA-IR and the Matsuda index. RESULTS Baseline and change in IAFA were significantly and independently associated with change in HOMA-IR and Matsuda index during follow-up. In multivariate analysis, IAFA and 10-year change in IAFA (Δ IAFA) was significantly and positively associated with 10-year HOMA-IR (p < 0.001) and significantly and negatively associated with 10-year Matsuda index (p < 0.001). The association with Matsuda index though was non-linear and best modeled as a quadratic function (Δ IAFA + Δ IAFA2). No significant associations in multivariate analyses were seen between thigh SCFA and insulin sensitivity or abdominal SCFA and HOMA-IR but an increase in abdominal SCFA was associated with diminished insulin sensitivity measured by the Matsuda index. CONCLUSIONS An increase in visceral adiposity predicts diminished insulin sensitivity over 10 years of follow-up independent of the size of this adipose depot at baseline.
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Affiliation(s)
- Amy W Liu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sun Ok Song
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - Tomoshige Hayashi
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko K Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Steven E Kahn
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Wilfred Y Fujimoto
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Edward J Boyko
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
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Ozeki Y, Masaki T, Yoshida Y, Okamoto M, Anai M, Gotoh K, Endo Y, Ohta M, Inomata M, Shibata H. Relationships between computed tomography-assessed density, abdominal fat volume, and glucose metabolism after sleeve gastrectomy in Japanese patients with obesity. Endocr J 2019; 66:605-613. [PMID: 31019152 DOI: 10.1507/endocrj.ej18-0543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this study, we investigated the relationships between body weight (BW), computed tomography (CT)-assessed abdominal adipose tissue, and the glycemic metabolic profile in obese Japanese patients following laparoscopic sleeve gastrectomy (LSG). This study analyzed adipose tissue compartments using CT methods before and 1 year after LSG. Thirty obese patients were studied, and variables measured included visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), density of VAT (VAT-D), and density of SAT (SAT-D). We also examined the parameters in patients according to whether they had type-2 diabetes (T2DM). LSG induced significant losses in BW, SAT, and VAT after LSG. Additionally, SAT-D and VAT-D both increased and fasting plasma glucose (FPG) and HbA1c, but not C-peptide, decreased after surgery. ΔSAT and ΔVAT were positively related, and ΔSAT-D and ΔVAT-D were negatively related to ΔBW and/or FPG. Furthermore, a multivariate regression model showed that total BW loss (TBWL) was closely related to ΔSAT (β = 0.84; p < 0.001) and ΔVAT-D (β = -0.45; p < 0.05) and improvement of FPG was related to ΔVAT (β = 0.61; p < 0.05) after LSG. Finally, ΔFPG was correlated with ΔVAT in 16 T2DM patients (r = 0.58; p < 0.05) but not in non-T2DM patients. TBWL was related to ΔSAT and ΔVAT-D, and improvement of FPG was related to ΔVAT in obese Japanese patients after LSG.
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Affiliation(s)
- Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Manabu Anai
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Yuichi Endo
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Masayuki Ohta
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
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Weng S, Zhou J, Chen X, Sun Y, Mao Z, Chai K. Prevalence and factors associated with nonalcoholic fatty pancreas disease and its severity in China. Medicine (Baltimore) 2018; 97:e11293. [PMID: 29953011 PMCID: PMC6039627 DOI: 10.1097/md.0000000000011293] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pancreatic lipidosis (nonalcoholic fatty pancreas disease, NAFPD) causes insulin resistance and dysfunction of pancreatic β-cells, with the risk of type 2 diabetes mellitus (T2DM). However, the prevalence and pathogenic factors associated with NAFPD are not clear. The aim of the study was to explore the prevalence of NAFPD in a Chinese adult population, and investigate factors associated with NAFPD aggravation.This was a cross-sectional study; 4419 subjects were enrolled for NAFPD screening and were divided into NAFPD (n = 488) and without NAFPD (n = 3930) groups. The sex, age, related concomitant diseases, general physical parameters, and serum glucose and lipid metabolism were compared between the 2 groups.The overall NAFPD prevalence was 11.05%, but increased with age. In those <55 years NAFPD prevalence was lower in females than males (P < .05), but prevalence was similar >55 years. Nonalcoholic fatty liver disease (NAFLD), T2DM, homeostasis model assessment-insulin resistance index, total cholesterol, triglyceride, lipoprotein, adiponectin, and glucagon-like peptide 1 (GLP-1) were the independent risk factors for NAFPD (P < .05). Analaysis of mild NAFPD (MN) and severe NAFPD (SN) subgroups, according to the extent of fat deposition, suggested that NAFLD, triglyceride, lipoprotein, and adiponectin were independent risk factors for NAFPD aggravation (P < .05).The NAFPD prevalence was about 11% in Chinese adults. Its development and progression was related to NAFLD, T2DM, insulin resistance, dyslipidemia, and GLP-1 levels. Severe NAFPD was associated with NAFLD and dyslipidemia.
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Affiliation(s)
- Siying Weng
- Department of Endocrinology, Ningbo Municipal Hospital of TCM, Affliated Hospital of Zhejiang Chineses Medical University, Ningbo City Department of Ultrasound, Ningbo Municipal Hospital of TCM, Affliated Hospital of Zhejiang Chineses Medical University, Ningbo City Department of Clinical Foundation of Chinese Medicine, College of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou City, China
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Rattarasarn C. Dysregulated lipid storage and its relationship with insulin resistance and cardiovascular risk factors in non-obese Asian patients with type 2 diabetes. Adipocyte 2018; 7:71-80. [PMID: 29411678 DOI: 10.1080/21623945.2018.1429784] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The prevalence of non-obese type 2 diabetes in Asians is up to 50%. This review aims to summarize the role of regional fat in the development of insulin resistance and cardiovascular risk in non-obese Asian type 2 diabetes as well as the role of intra-pancreatic fat and β-cell dysfunction. The body fat content of non-obese Asian type 2 diabetic patients is not different from that of non-diabetic subjects but the proportion of intra-abdominal and intra-hepatic fat are greater. Visceral fat contributes to insulin resistance and cardiovascular risk in non-obese Asian type 2 diabetes. Intra-hepatic fat and the hypertrophic abdominal subcutaneous adipocytes are associated with insulin resistance and cardiovascular risk in non-obese, non-diabetic Asian subjects. It may be true in non-obese Asian type 2 diabetic patients. The role of intra-myocellular lipid and insulin resistance is uncertain. Intra-pancreatic fat may not be involved in β-cell dysfunction in non-obese Asian type 2 diabetes.
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Affiliation(s)
- Chatchalit Rattarasarn
- Division of Endocrinology & Metabolism, Department of Medicine, Ramathibodi hospital, Mahidol university, Bangkok, Thailand
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Zhou J, Ren Y, Wang C, Li L, Zhang L, Wang B, Zhao Y, Han C, Zhang H, Yang X, Luo X, Pang C, Yin L, Feng T, Zhao J, Hu D, Zhang M. Association of change in waist circumference and dyslipidaemia risk: The rural Chinese cohort study. Diabetes Metab Res Rev 2018; 34. [PMID: 28886616 DOI: 10.1002/dmrr.2949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 08/08/2017] [Accepted: 08/30/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the association of change in waist circumference (WC) and incidence of dyslipidaemia in a cohort study of a rural Chinese population. METHODS Change in WC (ΔWC) was defined as the value at follow-up minus the corresponding value at baseline. Risk of dyslipidaemia associated with ΔWC was assessed by odds ratios and 95% confidence intervals in a logistic regression model, and the odds ratios were transformed to relative risks (RRs). RESULTS Among 7691 participants without dyslipidaemia at baseline, 3213 (41.78%) showed dyslipidaemia at 6 year follow-up. Risk of dyslipidaemia was decreased for participants with the first quartile of ΔWC and normal baseline WC (adjusted RR [aRR] = 0.79 [95% confidence interval: 0.64-0.98]) and was increased with the fourth quartile of ΔWC and male gender, age 18 to 30 years, age 31 to 50 years, or normal baseline WC (aRR = 1.55 [1.19-2.03], 2.40 [1.16-4.95], 1.32 [1.06-1.64], and 1.66 [1.35-2.04], respectively). The risk of dyslipidaemia increased with change in WC from normal at baseline to abnormal at follow-up for both genders (aRR = 1.88 [1.39-2.55] for men and 1.60 [1.30-1.97] for women) and decreased with abnormal baseline WC changed to normal WC for women (aRR = 0.61 [0.45-0.83]). CONCLUSIONS Dynamic change in waist circumference was closely related to the incidence of dyslipidaemia in a rural Chinese population. Waist circumference reduction could decrease dyslipidaemia risk, whereas WC increase may increase the risk. Interventions to control or reduce WC to within the normal range are important for early prevention of dyslipidaemia.
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Affiliation(s)
- Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
| | - Yongcheng Ren
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lu Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bingyuan Wang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yang Zhao
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chengyi Han
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongyan Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiangyu Yang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
| | - Chao Pang
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Lei Yin
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Tianping Feng
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Jingzhi Zhao
- Department of Prevention and Health Care, Military Hospital of Henan Province, Zhengzhou, China
| | - Dongsheng Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, China
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Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors. J Am Coll Cardiol 2017; 68:1509-21. [PMID: 27687192 DOI: 10.1016/j.jacc.2016.06.067] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 06/22/2016] [Accepted: 06/28/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles. OBJECTIVES This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors. METHODS Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm(3) and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans. RESULTS The mean fat volume change was an increase of 602 cm(3) for SAT and an increase of 703 cm(3) for VAT; the mean fat attenuation change was a decrease of 5.5 HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm(3) increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p < 0.05). Similar trends were observed for each additional 5 HU decrease in abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes. CONCLUSIONS Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes.
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Body mass index trajectory patterns and changes in visceral fat and glucose metabolism before the onset of type 2 diabetes. Sci Rep 2017; 7:43521. [PMID: 28266592 PMCID: PMC5339907 DOI: 10.1038/srep43521] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/25/2017] [Indexed: 12/31/2022] Open
Abstract
We investigated BMI trajectory patterns before diabetes diagnosis and examined associated changes in visceral adiposity and glucose metabolism. 23,978 non-diabetic Japanese participants (2,789 women) aged 30–64 years were assessed with a mean follow-up of 7.6 years. Diabetes was diagnosed via fasting glucose, HbA1c, and self-report. Latent-class trajectory analyses were performed to identify BMI trajectories. Longitudinal changes in BMI, visceral adiposity, and glucose metabolism were estimated using mixed models. 1,892 individuals developed diabetes. Three distinct BMI trajectories were identified in adults developing and not developing diabetes, respectively. Among adults developing diabetes, 47.3% were classified as “medium BMI” (n = 895), and had increased mean BMI within the obesity category before diagnosis. The “low BMI” group (38.4%, n = 726) had an initial mean BMI of 21.9 kg/m2, and demonstrated small weight gain. The “high BMI” group (n = 271) were severely obese and showed greater increase in BMI until diagnosis. All groups which developed diabetes showed absolute and/or relative increase in visceral fat and impaired β-cell compensation for insulin resistance. All groups not developing diabetes showed measured variables were relatively stable during observation. These data suggest that visceral fat gain may induce β-cell failure in compensation for insulin resistance, resulting in diabetes regardless of obesity level.
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Hwang YC, Fujimoto WY, Hayashi T, Kahn SE, Leonetti DL, Boyko EJ. Increased Visceral Adipose Tissue Is an Independent Predictor for Future Development of Atherogenic Dyslipidemia. J Clin Endocrinol Metab 2016; 101:678-85. [PMID: 26636177 PMCID: PMC4880131 DOI: 10.1210/jc.2015-3246] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
CONTEXT Atherogenic dyslipidemia is frequently observed in persons with a greater amount of visceral adipose tissue (VAT). However, it is still uncertain whether VAT is independently associated with the future development of atherogenic dyslipidemia. OBJECTIVES The aim of this study was to determine whether baseline and changes in VAT and subcutaneous adipose tissue (SAT) are associated with future development of atherogenic dyslipidemia independent of baseline lipid levels and standard anthropometric indices. DESIGN AND SETTING Community-based prospective cohort study with 5 years of follow-up. PARTICIPANTS A total of 452 Japanese Americans (240 men, 212 women), aged 34-75 years were assessed at baseline and after 5 years of follow-up. MAIN OUTCOME MEASURES Abdominal fat areas were measured by computed tomography. Atherogenic dyslipidemia was defined as one or more abnormalities in high-density lipoprotein (HDL) cholesterol, triglycerides, or non-HDL cholesterol levels. RESULTS Baseline VAT and change in VAT over 5 years were independently associated with log-transformed HDL cholesterol, log-transformed triglyceride, and non-HDL cholesterol after 5 years (standardized β = -0.126, 0.277, and 0.066 for baseline VAT, respectively, and -0.095, 0.223, and 0.090 for change in VAT, respectively). However, baseline and change in SAT were not associated with any future atherogenic lipid level. In multivariate logistic regression analysis, incremental change in VAT (odds ratio [95% confidence interval], 1.73 [1.20-2.48]; P = .003), triglycerides (4.01 [1.72-9.33]; P = .001), HDL cholesterol (0.32 [0.18-0.58]; P < .001), and non-HDL cholesterol (7.58 [4.43-12.95]; P < .001) were significantly associated with the future development of atherogenic dyslipidemia independent of age, sex, diastolic blood pressure, homeostasis model assessment insulin resistance, body mass index (BMI), change in BMI, SAT, and baseline atherogenic lipid levels. CONCLUSION Baseline and change in VAT were independent predictors for future development of atherogenic dyslipidemia. However, BMI, waist circumference, and SAT were not associated with future development of atherogenic dyslipidemia.
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Affiliation(s)
- You-Cheol Hwang
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
| | - Wilfred Y Fujimoto
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
| | - Tomoshige Hayashi
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
| | - Steven E Kahn
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
| | - Donna L Leonetti
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
| | - Edward J Boyko
- Seattle Epidemiologic Research and Information Center (Y.-C.H., E.J.B.), VA Puget Sound Health Care System, Seattle, Washington 98108; Division of Endocrinology and Metabolism (Y.-C.H.), Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 134-727, Korea; Division of Metabolism, Endocrinology and Nutrition (W.Y.F., S.E.K.), Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98105; Department of Preventive Medicine and Environmental Health (T.H.), Graduate School of Medicine, Osaka City University, Osaka 3-3-138, Japan; Hospital and Specialty Medicine Service (S.E.K.), VA Puget Sound Health Care System, Seattle, Washington 98108; and Department of Anthropology (D.L.L.), University of Washington, Seattle, Washington 98195
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Sharaye KO. Association of atherogenic indices and abdominal obesity indices among non obese adults in Zaria, Northern Nigeria. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/jpap2014.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Shah RV, Murthy VL, Abbasi SA, Blankstein R, Kwong RY, Goldfine AB, Jerosch-Herold M, Lima JAC, Ding J, Allison MA. Visceral adiposity and the risk of metabolic syndrome across body mass index: the MESA Study. JACC Cardiovasc Imaging 2014; 7:1221-35. [PMID: 25440591 PMCID: PMC4268163 DOI: 10.1016/j.jcmg.2014.07.017] [Citation(s) in RCA: 263] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/21/2014] [Accepted: 07/24/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES This study sought to evaluate differential effects of visceral fat (VF) and subcutaneous fat and their effects on metabolic syndrome (MetS) risk across body mass index (BMI) categories. BACKGROUND The regional distribution of adipose tissue is an emerging risk factor for cardiometabolic disease, although serial changes in fat distribution have not been extensively investigated. VF and its alterations over time may be a better marker for risk than BMI in normal weight and overweight or obese individuals. METHODS We studied 1,511 individuals in the MESA (Multi-Ethnic Study of Atherosclerosis) with adiposity assessment by computed tomography (CT). A total of 253 participants without MetS at initial scan underwent repeat CT (median interval 3.3 years). We used discrete Cox regression with net reclassification to investigate whether baseline and changes in VF area are associated with MetS. RESULTS Higher VF was associated with cardiometabolic risk and coronary artery calcification, regardless of BMI. After adjustment, VF was more strongly associated with incident MetS than subcutaneous fat regardless of weight, with a 28% greater MetS hazard per 100 cm(2)/m VF area and significant net reclassification (net reclassification index: 0.44, 95% confidence interval [CI]: 0.29 to 0.60) over clinical risk. In individuals with serial imaging, initial VF (hazard ratio: 1.24 per 100 cm(2)/m, 95% CI: 1.08 to 1.44 per 100 cm(2)/m, p = 0.003) and change in VF (hazard ratio: 1.05 per 5% change, 95% CI: 1.01 to 1.08 per 5% change, p = 0.02) were associated with MetS after adjustment. Changes in subcutaneous fat were not associated with incident MetS after adjustment for clinical risk and VF area. CONCLUSIONS VF is modestly associated with BMI. However, across BMI, a single measure of and longitudinal change in VF predict MetS, even accounting for weight changes. Visceral adiposity is essential to assessing cardiometabolic risk, regardless of age, race, or BMI, and may serve as a marker and target of therapy in cardiometabolic disease.
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Affiliation(s)
- Ravi V Shah
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Venkatesh L Murthy
- Department of Medicine (Cardiovascular Medicine Division) and Department of Radiology (Nuclear Medicine and Cardiothoracic Imaging Divisions), University of Michigan, Ann Arbor, Michigan.
| | - Siddique A Abbasi
- Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ron Blankstein
- Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Raymond Y Kwong
- Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Michael Jerosch-Herold
- Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, Massachusetts
| | - João A C Lima
- Division of Cardiology, Johns Hopkins Medical Institute, Baltimore, Maryland
| | - Jingzhong Ding
- Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Matthew A Allison
- Department of Family and Preventative Medicine, University of California-San Diego, San Diego, California
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Kishimoto M, Noda M. Effects of exenatide in a morbidly obese patient with type 2 diabetes. Diabetes Ther 2014; 5:323-32. [PMID: 24442463 PMCID: PMC4065292 DOI: 10.1007/s13300-014-0050-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The effect of exenatide in weight loss has been reported. Presented here is a case of a morbidly obese patient with type 2 diabetes using exenatide who dramatically lost her body weight in a year and experienced improved glycemic control. CASE REPORT Exenatide therapy was initiated for a 59-year-old morbidly obese Japanese woman with type 2 diabetes. To examine the effects of the exenatide treatment, continuous glucose monitoring was performed, and blood was drawn at 0, 30, 60, 120, and 180 min after breakfast to measure insulin, glucagon, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP) levels. After 1 year of exenatide therapy, the patient lost 37.5 kg, her glycemic control improved, and her insulin sensitivity recovered. The patient's levels of insulin, glucagon, active GLP-1, and total GIP also decreased after 1 year of exenatide treatment. CONCLUSION The exenatide treatment was effective for reducing body weight and improving glycemic control. After 1 year of exenatide treatment, decreased glucagon, active GLP-1, and total GIP levels were observed following a meal, suggesting that exenatide might affect these hormonal reactions.
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Affiliation(s)
- Miyako Kishimoto
- Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan,
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Villeneuve N, Pelletier-Beaumont E, Nazare JA, Lemieux I, Alméras N, Bergeron J, Tremblay A, Poirier P, Després JP. Interrelationships between changes in anthropometric variables and computed tomography indices of abdominal fat distribution in response to a 1-year physical activity–healthy eating lifestyle modification program in abdominally obese men. Appl Physiol Nutr Metab 2014; 39:503-11. [DOI: 10.1139/apnm-2013-0270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The objectives were to (i) measure the effects of a 1-year lifestyle modification program on body fat distribution/anthropometric variables; (ii) determine the interrelationships between changes in all these variables; and (iii) investigate whether there is a selective reduction in deep (DSAT) vs. superficial subcutaneous adipose tissue (SSAT) at the abdominal level following a 1-year lifestyle modification program. Anthropometric variables, body composition and abdominal and midthigh fat distribution were assessed at baseline and after 1 year in 109 sedentary, dyslipidemic and abdominally obese men. Reductions in anthropometric variables, skinfold thicknesses (except the trunk/extremity ratio) and fat mass as well as an increase in fat-free mass were observed after 1 year (p < 0.0001). Decreases in abdominal adipose tissue volumes were also noted (–23%, –26%, –18%, –19%, –17%, p < 0.0001 for total adipose tissue, visceral adipose tissue, subcutaneous adipose tissue, DSAT and SSAT, respectively). Adipose tissue areas at midthigh also decreased (–18%, –18%, –17%, p < 0.0001 for total, deep, and subcutaneous adipose tissue, respectively). A reduction (–9%, p < 0.0001) in low-attenuation muscle area and an increase (+1%, p < 0.05) in normal-attenuation muscle area were also observed. There was a positive relationship between changes in visceral adipose tissue and changes in DSAT (r = 0.65, p < 0.0001) or SSAT (r = 0.63, p < 0.0001). Although absolute changes in DSAT were greater than changes in SSAT, relative changes in both depots were similar, independent of changes in visceral adipose tissue. The 1-year lifestyle modification program therefore improved the body fat distribution pattern and midthigh muscle quality in abdominally obese men.
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Affiliation(s)
- Nicole Villeneuve
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Emilie Pelletier-Beaumont
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Julie-Anne Nazare
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
| | - Isabelle Lemieux
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
| | - Natalie Alméras
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jean Bergeron
- Lipid Research Center, CHUQ Research Center, Québec, QC G1V 4G2, Canada
| | - Angelo Tremblay
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Paul Poirier
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Faculty of Pharmacy, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jean-Pierre Després
- Centre de recherche de l’Institut universitaire de cardiologie et de pneumologie de Québec, Pavilion Marguerite-D’Youville, 2725 chemin Ste-Foy, Québec QC G1V 4G5, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
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20
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Aging attenuates the association of central obesity with the accumulation of metabolic risk factors when assessed using the waist circumference measured at the umbilical level (the Japanese standard method). Nutr Diabetes 2013; 3:e96. [PMID: 24276151 PMCID: PMC3841441 DOI: 10.1038/nutd.2013.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 09/27/2013] [Accepted: 10/23/2013] [Indexed: 12/22/2022] Open
Abstract
Objective: The objective of this study was to clarify the generation and gender differences in the association between central obesity and the accumulation of metabolic risk factors (RFs) in the Japanese population. Material and methods: A total of 12 389 subjects (age: 18–80 years) without receiving medication for diabetes, dyslipidemia or hypertension were enrolled in this study and divided according to age and gender. In each group, we performed analyses as follows: (1) a receiver operating characteristic (ROC) analysis to evaluate the utility of the waist circumference (WC) for detecting subjects with multiple RFs of metabolic syndrome (MS); (2) a cross-sectional study to examine the relationship between the WC and the odds ratio (OR) for detecting those subjects and (3) a longitudinal study to examine how longitudinal changes (Δ) in WC over a 1-year period affected the values of each metabolic RF. Results: With age, the WC cutoff values yielding the maximum Youden index for detecting subjects with multiple RFs increased only in women, and the areas under the curves of the ROC analysis of WC for detecting those subjects decreased in both genders. The positive correlation between the WC and the OR for detecting subjects with multiple RFs became weaker with age, especially in women. In the longitudinal study, the significant correlation between ΔWC and Δ each metabolic RF, except for hypertension, and between ΔWC and Δ the number of RFs became weaker with age in women, whereas the significant correlation between ΔWC and Δ the number of RFs was not affected with age in men. In women aged ⩾60 years, none of the changes in each metabolic RF were significantly associated with ΔWC. Conclusions: Aging attenuates the association of central obesity with the accumulation of metabolic RFs, especially in women.
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Okuma H, Okada T, Abe Y, Saito E, Iwata F, Hara M, Ayusawa M, Mugishima H, Takahashi S. Abdominal adiposity is associated with high-density lipoprotein subclasses in Japanese schoolchildren. Clin Chim Acta 2013; 425:80-4. [DOI: 10.1016/j.cca.2013.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/12/2013] [Accepted: 07/22/2013] [Indexed: 11/30/2022]
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Matsushita Y, Nakagawa T, Yamamoto S, Takahashi Y, Yokoyama T, Mizoue T, Noda M. Effect of longitudinal changes in visceral fat area on incidence of metabolic risk factors: the Hitachi health study. Obesity (Silver Spring) 2013; 21:2126-9. [PMID: 23408393 DOI: 10.1002/oby.20347] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 12/06/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the incidences of metabolic risk factors according to changes in visceral fat area (VFA) in a large Japanese population. DESIGN AND METHODS The subjects were 973 men who received a computed tomography (CT) examination in health checkups twice (2004-2005 and 2007-2008), and not having two or more of metabolic risk factors (except for the waist circumference) in 2004-2005. VFA was measured using CT. To assess the potential influence of changes in VFA for the 3-year incidences of each metabolic risk factor and clustering metabolic risk factors, logistic regression analyses were used. RESULTS A significant association was observed between the change in VFA and the components of the metabolic risk factors. Incidences of the components of the metabolic risk factors were significantly higher among subjects with a larger increase in VFA and were significantly lower among subjects with a larger decrease in VFA (trend P < 0.001). Significant increases in the odds ratios for the incidences of high triglycerides and low high-density lipoprotein cholesterol level were observed among subjects with ≥50 cm(2) VFA increase. CONCLUSIONS The adoption of a lifestyle that does not increase the VFA is important for preventing metabolic syndrome.
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Affiliation(s)
- Yumi Matsushita
- Department of Clinical Research, National Center for Global Health and Medicine, Tokyo, Japan
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23
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van der Wijden CL, Delemarre-van der Waal HA, van Mechelen W, van Poppel MNM. The concurrent validity between leptin, BMI and skin folds during pregnancy and the year after. Nutr Diabetes 2013; 3:e86. [PMID: 24018614 PMCID: PMC3789130 DOI: 10.1038/nutd.2013.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 06/27/2013] [Accepted: 07/24/2013] [Indexed: 12/11/2022] Open
Abstract
Background: From a public health perspective it is important to know which of the currently used methods to estimate changes in maternal body fat during pregnancy and the year thereafter is the most adequate. Objectives: To evaluate the concurrent validity between leptin and surrogates of fat measures: body mass index (BMI) and the sum of four skin folds. Design: Data from the New Life(style) intervention study were analysed as a cohort study. Setting: Midwife practices in The Netherlands. Population: Healthy pregnant nulliparous women. Methods: Anthropometric measurements were done and blood was collected at 15, 25 and 35 weeks of pregnancy and at 6, 26 and 52 weeks after delivery. Data were used if at least 4 out of the 6 measurements were available, leaving 87 women in the analyses. Spearman's correlation coefficients between leptin and BMI and between leptin and the sum of skin folds were calculated for each time point and for the changes between the time points. Results: Correlations between leptin and BMI varied from 0.69 to 0.81. Correlations between leptin and the sum of skin folds were comparable, varying between 0.65 and 0.81. Correlations between changes in leptin and changes in BMI and the sum of skin folds, respectively, were much lower compared with cross-sectional correlations. Conclusion: Because of the high correlation among the three methods and because of the overlapping intervals, all methods seem to be equally adequate to estimate changes in maternal body fat during pregnancy and the year thereafter.
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Affiliation(s)
- C L van der Wijden
- 1] Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands [2] Department of Gynaecology, Medisch Centrum Jan van Goyen, Amsterdam, The Netherlands
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Goto M, Morita A, Goto A, Deura K, Sasaki S, Aiba N, Shimbo T, Terauchi Y, Miyachi M, Noda M, Watanabe S. Reduction in adiposity, β-cell function, insulin sensitivity, and cardiovascular risk factors: a prospective study among Japanese with obesity. PLoS One 2013; 8:e57964. [PMID: 23483954 PMCID: PMC3590246 DOI: 10.1371/journal.pone.0057964] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/29/2013] [Indexed: 02/05/2023] Open
Abstract
Background A reduction in adiposity may be associated with an improvement in insulin sensitivity and β-cell function as well as cardiovascular disease (CVD) risk factors; however, few studies have investigated these associations in a longitudinal setting. Methods To investigate these associations over a 1-year period, we conducted an observational analysis of 196 Japanese subjects with obesity in the Saku Control Obesity Program. We investigated the relations between changes in adiposity (body mass index [BMI], waist circumference, subcutaneous fat area [SFAT], and visceral fat area [VFAT]) and changes in HbA1c, fasting plasma glucose (FPG), insulin sensitivity index (ISI), the homeostasis model assessment β cell function (HOMA-β), lipids, and blood pressure. Results All adiposity changes were positively associated with HbA1c and FPG changes. Reductions in BMI and VFAT were associated with HOMA-β reduction. Reductions in all adiposity measures were associated with an improvement in the ISI. Changes in most adiposity measures were positively associated with changes in blood pressure and lipid levels, except for LDL. Conclusion The present findings provide additional supportive evidence indicating that a reduction in adiposity may lead to an improvement in insulin sensitivity and the reduction of CVD risk factors in obese individuals.
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Affiliation(s)
- Maki Goto
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- National Institute of Health and Nutrition, Tokyo, Japan
| | - Akemi Morita
- National Institute of Health and Nutrition, Tokyo, Japan
- Department of Nutrition, College of Nutrition, Koshien University, Hyogo, Japan
| | - Atsushi Goto
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- National Institute of Health and Nutrition, Tokyo, Japan
| | | | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, University of Tokyo, Tokyo, Japan
| | - Naomi Aiba
- Department of Nutrition and Life Science, Kanagawa Institute of Technology, Kanagawa, Japan
| | - Takuro Shimbo
- Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Mitsuhiko Noda
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Diabetes and Metabolic Medicine, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Shaw Watanabe
- National Institute of Health and Nutrition, Tokyo, Japan
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Berings M, Wehlou C, Verrijken A, Deschepper E, Mertens I, Kaufman JM, Van Gaal LF, Ouwens DM, Ruige JB. Glucose intolerance and the amount of visceral adipose tissue contribute to an increase in circulating triglyceride concentrations in Caucasian obese females. PLoS One 2012; 7:e45145. [PMID: 23028811 PMCID: PMC3460993 DOI: 10.1371/journal.pone.0045145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Accepted: 08/13/2012] [Indexed: 01/05/2023] Open
Abstract
Context Lipotoxicity is a risk factor for developing obesity-related metabolic complications, including non-alcoholic fatty liver disease, type 2 diabetes (DM2), cardiovascular disease and stroke. Yet, the mechanisms underlying the development of lipotoxicity itself remain poorly understood. Here, we investigated whether glucose intolerance aggravates lipotoxicity by evaluating the association between triglyceride (TG) concentrations and glucose tolerance status in a cross-sectional study on obese Caucasian women at risk for DM2. Methods 913 obese females unknown to have diabetes were recruited (mean age: 41.2±SD 12.3; median BMI: 36.2, IQR 32.9–40.2). Visceral (VAT) and subcutaneous abdominal adipose tissue volumes were quantified with computed tomography. Glucose, insulin, and triglyceride concentrations were determined in fasting state and following a 75 gram oral glucose tolerance test. Results Based on fasting and 2 h post-load glucose levels, 27% of the women had impaired glucose tolerance (IGT), and 8% had newly diagnosed DM2. Fasting TG concentrations were similar between the IGT- and DM2-groups, and increased as compared to women with normal glucose tolerance (NGT). Even when adjusting for age, hip circumference and VAT, fasting TG concentrations remained elevated as compared to NGT. Mixed modelling analysis of post-load responses showed that TG concentrations declined more slowly in the DM2-group as compared to IGT and NGT. However, when adjusting for VAT the difference in decline between the glucose tolerance groups disappeared. Conclusions Glucose intolerance associates with elevated fasting TG concentrations in obese Caucasian women. We propose that glucose intolerance and increased VAT reduce lipid disposal mechanisms and may accelerate lipotoxicity.
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Affiliation(s)
- Margot Berings
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Charline Wehlou
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | | | - Ilse Mertens
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Luc F. Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - D. Margriet Ouwens
- German Diabetes Center, Institute for Clinical Biochemistry and Pathobiochemistry, Düsseldorf, Germany
| | - Johannes B. Ruige
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
- * E-mail:
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