Key result
A 1cm increase in visceral adipose tissue assessed by ultrasound was associated with approximately 5% lower insulin sensitivity and 0.18 mmol/l higher 2-hour glucose, independent of waist circumference.
Why the study?
Are ultrasound measures of abdominal fat distribution associated with indices of glucose metabolism in a population at high risk of type 2 diabetes?
Cross-Sectional (n=1,342)
Yes
Are ultrasound measures of abdominal fat distribution associated with indices of glucose metabolism in a population at high risk of type 2 diabetes?
Effect estimate: 0.18 mmol/l higher per 1cm increase
p-value: p=0.001
Visceral and subcutaneous adipose tissue assessed by ultrasonography are significantly associated with glucose metabolism and insulin resistance in patients at high risk for type 2 diabetes, independent of other obesity measures.
Ultrasound visceral fat measures were associated with worse glucose metabolism in high-risk patients; leaves open incremental value beyond BMI for T2D prediction.
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.
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Philipsen et al. (2015) conducted a cross-sectional in High risk of type 2 diabetes (n=1,342). Visceral adipose tissue (VAT) measured by ultrasound vs. Lower visceral adipose tissue (continuous) was evaluated on 2-hour glucose level (0.18 mmol/l higher per 1cm increase, p=0.001). A 1cm increase in visceral adipose tissue assessed by ultrasound was associated with approximately 5% lower insulin sensitivity and 0.18 mmol/l higher 2-hour glucose, independent of waist circumference.
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