The role of insulin resistance in the relation of visceral, abdominal subcutaneous and total body fat to cardiovascular function

Abstract The role of adiponectin production for the circulating protein concentration in human obesity and insulin resistance is unclear. We measured serum concentration and sc adipose tissue secretion rate of adiponectin in 77 obese and 23 nonobese women with a varying degree of insulin sensitivity. The serum adiponectin concentration was similar in both groups. In obesity, adiponectin adipose tissue secretion rate per weight unit was reduced by 30% (P = 0.01), whereas total body fat secretion rate was increased by 100% (P < 0.0001). In the group being most insulin resistant (1/3), serum concentration (P < 0.001) and adipose tissue secretion rate per tissue weight (P < 0.05) were reduced, whereas total body fat secretion rate was increased (P < 0.01), by about 30%. The adipose tissue secretion rate of adiponectin was related to the serum concentration (P = 0.005) but explained only about 10% of the interindividual variation in circulating adiponectin and insulin sensitivity. The plasma adiponectin half life was long, 2.5 h. In conclusion, the role of protein secretion for the circulating concentration of adiponectin and insulin sensitivity under these conditions is minor because adiponectin turnover rate is slow. Although increased in obesity and insulin resistance, total body production of adiponectin is insufficient to raise the circulating concentration, may be due to reduced secretion rate per tissue unit.

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Body mass index and waist circumference are better predictors of insulin resistance than total body fat percentage in middle-aged and elderly Taiwanese

Medicine ◽

10.1097/md.0000000000008126 ◽

2017 ◽

Vol 96 (39) ◽

pp. e8126 ◽

Cited By ~ 19

Author(s):

Yiu-Hua Cheng ◽

Yu-Chung Tsao ◽

I-Shiang Tzeng ◽

Hai-Hua Chuang ◽

Wen-Cheng Li ◽

...

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Waist Circumference ◽

Body Mass ◽

Body Fat ◽

Body Fat Percentage ◽

Middle Aged ◽

Fat Percentage ◽

Total Body Fat ◽

Total Body

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Ethnic Variation in Fat and Lean Body Mass and the Association with Insulin Resistance

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2009-1030 ◽

2009 ◽

Vol 94 (12) ◽

pp. 4696-4702 ◽

Cited By ~ 78

Author(s):

Scott A. Lear ◽

Simi Kohli ◽

Gregory P. Bondy ◽

André Tchernof ◽

Allan D. Sniderman

Keyword(s):

Insulin Resistance ◽

Ethnic Groups ◽

Body Mass ◽

Body Fat ◽

South Asian ◽

Lean Mass ◽

South Asians ◽

Model Assessment ◽

Total Body Fat ◽

Total Body

Context: Body fat distribution varies among different ethnic groups, yet less is known regarding differences in lean mass and how this may affect insulin resistance. Objective: Our objective was to compare total body fat to lean mass ratio (F:LM) in Aboriginal, Chinese, European, and South Asian individuals with differences in insulin resistance. Participants, Design, and Setting: Aboriginal (196), Chinese (222), European (202), and South Asian (208) individuals were recruited across a range of body mass index to participate in this cross-sectional community study. Main Outcome Measures: Total body fat, lean mass, and insulin resistance were assessed using homeostasis model assessment (HOMA). Results: After adjustment for confounders and at a given body fat, South Asian men had less lean mass than Aboriginal [3.42 kg less; 95% confidence interval (CI) = 1.55–5.29], Chinese (3.01 kg less; 95% CI = 1.33–4.70), and European (3.57 kg less; 95% CI = 1.82–5.33) men, whereas South Asian women had less lean mass than Aboriginal (1.98 kg less; 95% CI = 0.45–3.50), Chinese (2.24 kg less; 95% CI = 0.81–3.68), and European (2.97 kg less; 95% CI = 1.67–4.27) women. In adjusted models, F:LM was higher in South Asian compared with Chinese and European men and higher in South Asian compared with Aboriginal, Chinese, and European women (P < 0.01 for all). Insulin and HOMA were greatest in South Asians after adjustment; however, these differences were no longer apparent when F:LM was considered. Conclusions: South Asians have a phenotype of high fat mass and low lean mass, which may account for greater levels of insulin and HOMA compared with other ethnic groups.

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Change in Visceral Fat and Total Body Fat and the Effect on Cardiometabolic Risk Factors During Transgender Hormone Therapy

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab616 ◽

2021 ◽

Author(s):

Maartje Klaver ◽

Daan van Velzen ◽

Christel de Blok ◽

Nienke Nota ◽

Chantal Wiepjes ◽

...

Keyword(s):

Insulin Resistance ◽

Hormone Therapy ◽

Body Fat ◽

Visceral Fat ◽

Cardiometabolic Risk ◽

Trans Men ◽

Total Body Fat ◽

In Trans ◽

Trans Women ◽

Total Body

Abstract Introduction Excess visceral fat increases the risk of type 2 diabetes and cardiovascular disease and is influenced by sex hormones. Our aim was to investigate changes in visceral fat and the ratio of visceral fat to total body fat (VAT/TBF) and their associations with changes in lipids and insulin resistance after 1 year of hormone therapy in trans persons. Methods In 179 trans women and 162 trans men, changes in total body and visceral fat estimated with dual-energy X-ray absorptiometry before and after 1 year of hormone therapy were related to lipids and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR)] with linear regression analysis. Results In trans women, total body fat increased by 4.0 kg (95% CI 3.4, 4.7), while the amount of visceral fat did not change (−2 grams; 95% CI −15, 11), albeit with a large range from −318 to 281, resulting in a decrease in the VAT/TBF ratio of 17% (95% CI 15, 19). In trans men, total body fat decreased with 2.8 kg (95% CI 2.2, 3.5), while the amount of visceral fat did not change (3 g; 95% CI −10, 16; range −372, 311), increasing the VAT/TBF ratio by 14% (95% CI 10, 17). In both groups, VAT/TBF was not associated with changes in blood lipids or HOMA-IR. Conclusions Hormone therapy in trans women and trans men resulted in changes in VAT/TBF, mainly due to changes in total body fat and were unrelated to changes in cardiometabolic risk factors, which suggests that any unfavorable cardiometabolic effects of hormone therapy are not mediated by changes in visceral fat or VAT/TBF.

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Total Body Fat and Central Fat Mass Independently Predict Insulin Resistance but Not Hyperandrogenemia In Women With Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-2786 ◽

2015 ◽

Vol 100 (2) ◽

pp. 661-669 ◽

Cited By ~ 28

Author(s):

Flavia Tosi ◽

Daniela Di Sarra ◽

Jean-Marc Kaufman ◽

Cecilia Bonin ◽

Rosa Moretta ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Body Fat ◽

Fat Mass ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Total Body Fat ◽

Central Fat ◽

Total Body

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Subcutaneous Fat Fibrosis Links Obesity to Insulin Resistance in Chinese Americans

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-02301 ◽

2018 ◽

Vol 103 (9) ◽

pp. 3194-3204 ◽

Cited By ~ 11

Author(s):

Diana L Alba ◽

Jeffrey A Farooq ◽

Matthew Y C Lin ◽

Anne L Schafer ◽

John Shepherd ◽

...

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

San Francisco ◽

Body Fat ◽

Subcutaneous Fat ◽

Chinese Americans ◽

Mrna Levels ◽

Model Assessment ◽

Total Body Fat ◽

Total Body

Abstract Objective Type 2 diabetes presents at a lower body mass index (BMI) in Chinese individuals than in white individuals. We sought to determine the role of subcutaneous adipose tissue (SCAT)–intrinsic factors, vs BMI or adiposity per se, in the vulnerability of Chinese individuals to obesity-associated impairment of insulin sensitivity. Research Design and Methods Thirty-two Chinese and 30 white men and women from a cohort in the San Francisco Bay Area underwent anthropometric measurements, body composition (dual-energy X-ray absorptiometry) analyses, and measurement of fasting plasma glucose and insulin. Forty-eight also provided abdominal SCAT samples for transcriptional and biochemical analyses of tissue fibrosis. Results BMI correlated with total body fat in white (r = 0.74, P < 0.001) but not Chinese individuals, whereas BMI correlated with visceral adipose tissue (VAT) accrual in both ethnicities (r = 0.88 and 0.81, respectively; P < 0.01). Insulin resistance (homeostatic model assessment of insulin resistance) worsened with VAT mass, but not total body fat, in Chinese subjects (r = 0.63, P < 0.01), whereas it worsened with both in white individuals. By contrast, SCAT mRNA levels of genes encoding profibrotic proteins rose remarkably along with both BMI and VAT mass in Chinese but not white subjects. Similarly, SCAT levels of hydroxyproline, an indicator of tissue collagen content that correlated with increasing VAT mass, were higher in Chinese vs white subjects, particularly in the setting of relative insulin resistance. Conclusions Our findings dissociate BMI from adiposity in Chinese individuals and instead highlight SCAT fibrosis as a process linked to visceral adiposity and insulin resistance in this group.

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Vitamin B12 Associated to Total Body Fat in Healthy Non-Obese Adults According to Insulin Resistance Status

Metabolism ◽

10.1016/j.metabol.2020.154619 ◽

2021 ◽

Vol 116 ◽

pp. 154619

Author(s):

Christoper A. Alarcon-Ruiz ◽

Betzi Pantoja-Torres ◽

Mirella Guarnizo-Poma ◽

Herbert Lazaro-Alcantara ◽

Socorro Paico-Palacios ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin B12 ◽

Body Fat ◽

Obese Adults ◽

Total Body Fat ◽

Total Body

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Leg and arm adiposity is inversely associated with diastolic hypertension in young and middle-aged United States adults

Clinical Hypertension ◽

10.1186/s40885-021-00190-2 ◽

2022 ◽

Vol 28 (1) ◽

Author(s):

Aayush Visaria ◽

David Lo ◽

Pranay Maniar ◽

Bhoomi Dave ◽

Parag Joshi

Keyword(s):

Body Fat ◽

Survey Design ◽

Fat Distribution ◽

Average Standard Deviation ◽

Health And Nutrition ◽

Diastolic Hypertension ◽

Total Body Fat ◽

Total Body ◽

Proportional Distribution

Abstract Background We sought to determine the association between appendicular adiposity and hypertension, with the purpose of better understanding the role of body fat distribution on blood pressure (BP). Methods We included 7411 adults aged 20 to 59 who were not taking antihypertensives and without cardiovascular disease from the 2011 to 2018 National Health and Nutrition Examination Surveys. Leg & arm adiposity, determined via dual-energy X-ray absorptiometry scans, was defined as percent of total body fat present in legs/arms (leg/total%, arm/total%). Measures were categorized into sex-specific tertiles. We estimated change in BP and odds ratios (ORs) of hypertension (BP ≥ 130/80) and hypertension subtypes using multivariable, survey design-adjusted linear & logistic regression, respectively. Results Of the participants, 49% were female, the average (standard deviation) age was 37.4 (0.3) years, and 24% had hypertension. Those in the highest tertile (T3) of leg/total% had 30% decreased adjusted ORs (aOR) of hypertension compared to the lowest tertile (T1; aOR, 0.70; 95% confidence interval [95% CI], 0.55–0.89). This association was not significant for arm/total% (0.89, 0.68–1.17). T3 of leg/total% was associated with 49% lower, 41% lower, and unchanged relative odds of isolated diastolic hypertension (IDH), systolic-diastolic hypertension (SDH), and isolated systolic hypertension (ISH) compared to T1 (IDH: 0.51, 0.37–0.70; SDH: 0.59, 0.43–0.80; ISH: 1.06, 0.70–1.59). For every 10% increase in leg/total%, diastolic BP decreased by an adjusted mean 3.5 mmHg (95% CI, − 4.8 to − 2.2) in males and 1.8 mmHg (95% CI, − 2.8 to − 0.8) in females (P < 0.001 for both). Conclusions A greater proportional distribution of fat around the legs is inversely, independently associated with hypertension, and more specifically, diastolic hypertension (IDH and SDH).

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