Abstract Aims Adipose tissue insulin resistance, reflecting impaired insulin‐mediated suppression of lipolysis in adipose tissue, is recognized as an early metabolic abnormality. However, its associations with fasting blood glucose (FBG) and haemoglobin A1c (HbA1c) have not been well characterized in adults without diabetes. The study aims to evaluate these associations under conditions of normoglycaemia and prediabetes. Materials and Methods The study enrolled 9011 adults without diabetes. Adipose tissue insulin resistance index (Adipo‐IR) was calculated by the product of fasting insulin and free fatty acid levels. We categorized FBGand HbA1c separately into three groups. We conducted logistic regression after adjustment for potential confounders. Results Adipo‐IR gradually increased with the increase of FBG categories and HbA1c categories. The positive association between Adipo‐IR and FBG levels varied by body mass index (BMI) ( p for interaction <0.001), with a strengthened relationship in the condition of BMI <24 kg/m 2 . One unit increase in log‐Adipo‐IR was associated with 2.74 (95% CI: 2.02, 3.73, p < 0.001) times odds of having high FBG levels (denoted as FBG ≥5.6 mmol/L) after adjustment for other risk factors in participants with BMI <24 kg/m 2 . However, the ORs turned out to be 1.67 (95% CI: 1.36, 2.07, p < 0.001) and 1.30 (95% CI: 0.98, 1.74, p = 0.07) in participants with BMI 24 to <28 and ≥28 kg/m 2 , respectively. The positive associations between Adipo‐IR and HbA1c levels were also observed among participants with body mass index <24, 24 to <28, and ≥28 kg/m 2 , and among females and males, respectively. Conclusions Adipose tissue insulin resistance demonstrated a significant dose–response relationship with both FBG and HbA1c levels in individuals without diabetes, which may reflect early glycaemic alterations. The association between Adipo‐IR and FBG was more pronounced under conditions of normal or low body weight.
Wei et al. (Mon,) studied this question.