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Associations between ultrasound measures of abdominal fat distribution and indices of glucose metabolism in a population at high risk of type 2 diabetes: the ADDITION-PRO study.

Philipsen A, Jørgensen ME, Vistisen D, Sandbaek A, Almdal TP, Christiansen JS, Lauritzen T, Witte DR - PLoS ONE (2015)

Bottom Line: Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile.After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue.After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001).

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center A/S, Gentofte, Denmark.

ABSTRACT

Aims: Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile. We assessed whether similar associations can be found with ultrasonography, by quantifying the strength of the relationship between different measures of obesity and indices of glucose metabolism in a population at high risk of type 2 diabetes.

Methods: A cross-sectional analysis of 1342 participants of the ADDITION-PRO study. We measured visceral adipose tissue and subcutaneous adipose tissue with ultrasonography, anthropometrics and body fat percentage by bioelectrical impedance. Indices of glucose metabolism were derived from a three point oral glucose tolerance test. Linear regression of obesity measures on indices of glucose metabolism was performed.

Results: Mean age was 66.2 years, BMI 26.9kg/m2, subcutaneous adipose tissue 2.5cm and visceral adipose tissue 8.0cm. All measures of obesity were positively associated with indicators of glycaemia and inversely associated with indicators of insulin sensitivity. Associations were of equivalent magnitude except for subcutaneous adipose tissue and the visceral/subcutaneous adipose tissue ratio, which showed weaker associations. One standard deviation difference in BMI, visceral adipose tissue, waist circumference, waist/height ratio and body fat percentage corresponded approximately to 0.2mmol/l higher fasting glucose, 0.7mmol/l higher 2-hr glucose, 0.06-0.1% higher HbA1c, 30 % lower HOMA index of insulin sensitivity, 20% lower Gutt's index of insulin sensitivity, and 100 unit higher Stumvoll's index of beta-cell function. After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue. After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001).

Conclusion: Visceral and subcutaneous adipose tissue assessed by ultrasonography are significantly associated with glucose metabolism, even after adjustment for other measures of obesity.

No MeSH data available.


Related in: MedlinePlus

Examples of ultrasound images of VAT and SAT.
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pone.0123062.g002: Examples of ultrasound images of VAT and SAT.

Mentions: Abdominal fat distribution was assessed by ultrasonography (Logiq 9 machine, GE Healthcare, Waukesha, WI, USA) according to a strict validated protocol [9–11]. With the participant lying down, VAT thickness was defined as the depth (cm) from the peritoneum to the lumbar spine, and SAT thickness as the depth (cm) from the skin to the linea alba. Both measurements were made where the xyphoid line crosses the waistline (Fig 1). Visceral fat was measured using a 4C abdominal convex transducer placed longitudinally and subcutaneous fat with a 9L small parts linear transducer placed transversely. Scan depth was individually set for each image in order to best visualise anatomical structures. Measurements were performed at the end of a quiet expiration using minimal pressure on the transducer so as not to compress the fat tissue. Fig 2 shows examples of ultrasound assessment of VAT and SAT.


Associations between ultrasound measures of abdominal fat distribution and indices of glucose metabolism in a population at high risk of type 2 diabetes: the ADDITION-PRO study.

Philipsen A, Jørgensen ME, Vistisen D, Sandbaek A, Almdal TP, Christiansen JS, Lauritzen T, Witte DR - PLoS ONE (2015)

Examples of ultrasound images of VAT and SAT.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388843&req=5

pone.0123062.g002: Examples of ultrasound images of VAT and SAT.
Mentions: Abdominal fat distribution was assessed by ultrasonography (Logiq 9 machine, GE Healthcare, Waukesha, WI, USA) according to a strict validated protocol [9–11]. With the participant lying down, VAT thickness was defined as the depth (cm) from the peritoneum to the lumbar spine, and SAT thickness as the depth (cm) from the skin to the linea alba. Both measurements were made where the xyphoid line crosses the waistline (Fig 1). Visceral fat was measured using a 4C abdominal convex transducer placed longitudinally and subcutaneous fat with a 9L small parts linear transducer placed transversely. Scan depth was individually set for each image in order to best visualise anatomical structures. Measurements were performed at the end of a quiet expiration using minimal pressure on the transducer so as not to compress the fat tissue. Fig 2 shows examples of ultrasound assessment of VAT and SAT.

Bottom Line: Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile.After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue.After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001).

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center A/S, Gentofte, Denmark.

ABSTRACT

Aims: Visceral adipose tissue measured by CT or MRI is strongly associated with an adverse metabolic risk profile. We assessed whether similar associations can be found with ultrasonography, by quantifying the strength of the relationship between different measures of obesity and indices of glucose metabolism in a population at high risk of type 2 diabetes.

Methods: A cross-sectional analysis of 1342 participants of the ADDITION-PRO study. We measured visceral adipose tissue and subcutaneous adipose tissue with ultrasonography, anthropometrics and body fat percentage by bioelectrical impedance. Indices of glucose metabolism were derived from a three point oral glucose tolerance test. Linear regression of obesity measures on indices of glucose metabolism was performed.

Results: Mean age was 66.2 years, BMI 26.9kg/m2, subcutaneous adipose tissue 2.5cm and visceral adipose tissue 8.0cm. All measures of obesity were positively associated with indicators of glycaemia and inversely associated with indicators of insulin sensitivity. Associations were of equivalent magnitude except for subcutaneous adipose tissue and the visceral/subcutaneous adipose tissue ratio, which showed weaker associations. One standard deviation difference in BMI, visceral adipose tissue, waist circumference, waist/height ratio and body fat percentage corresponded approximately to 0.2mmol/l higher fasting glucose, 0.7mmol/l higher 2-hr glucose, 0.06-0.1% higher HbA1c, 30 % lower HOMA index of insulin sensitivity, 20% lower Gutt's index of insulin sensitivity, and 100 unit higher Stumvoll's index of beta-cell function. After adjustment for waist circumference visceral adipose tissue was still significantly associated with glucose intolerance and insulin resistance, whereas there was a trend towards inverse or no associations with subcutaneous adipose tissue. After adjustment, a 1cm increase in visceral adipose tissue was associated with ~5% lower insulin sensitivity (p≤0.0004) and ~0.18mmol/l higher 2-hr glucose (p≤0.001).

Conclusion: Visceral and subcutaneous adipose tissue assessed by ultrasonography are significantly associated with glucose metabolism, even after adjustment for other measures of obesity.

No MeSH data available.


Related in: MedlinePlus