Visceral adipose tissue accumulation and cardiovascular disease risk profile in postmenopausal women with impaired glucose tolerance or type 2 diabetes

OBJECTIVE: Women with impaired glucose tolerance (IGT) and type 2 diabetes (T2D) are more at risk of cardiovascular disease. The aim of this study was to test the hypothesis that increased visceral adipose tissue (VAT) could explain to a large extent alterations in the cardiovascular disease risk profile of postmenopausal women with IGT or T2D. DESIGN, PATIENTS AND MEASUREMENTS: Sixty-two women with normal glucose tolerance (NGT), 33 with IGT and 18 with de novo diagnosed T2D were tested. The sample was further divided into five groups: (i) NGT-low VAT (<130 cm(2) ); (ii) NGT-high VAT (≥130 cm(2)); (iii) IGT-low VAT (<130 cm(2) ); (iv) IGT-high VAT (≥130 cm(2) ) and (v) T2D. RESULTS: Women with T2D, women with IGT-high VAT and those with NGT-high VAT all had lower insulin sensitivity as determined by the euglycaemic-hyperinsulinaemic clamp (M_I), higher triglyceride (TG), lower HDL(2)-cholesterol (chol) levels and higher levels of high-sensitivity C-reactive protein than women with NGT-low VAT. Only differences in M_I and early insulin response (EIR) were observed between women with IGT-high VAT and those with NGT-high VAT (lower values in IGT-high VAT). Women with T2D had lower M_I and EIR as well as higher plasma TG and lower plasma Apo A1 and HDL-chol concentrations than women with NGT-high VAT. CONCLUSIONS: Our results suggest that increase in VAT accumulation usually found in women with IGT explains to a large extent the deterioration in their plasma lipid-lipoprotein and inflammatory profile. However, factors other than VAT are involved in explaining the high TG-low HDL dyslipidaemia observed in women with T2D.