Subdivisions of subcutaneous abdominal adipose tissue and insulin resistance

2000 ◽  
Vol 278 (5) ◽  
pp. E941-E948 ◽  
Author(s):  
David E. Kelley ◽  
F. Leland Thaete ◽  
Fred Troost ◽  
Trina Huwe ◽  
Bret H. Goodpaster
Keyword(s):  
Insulin Resistance ◽  
Adipose Tissue ◽  
Subcutaneous Fat ◽  
Area Under The Curve ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Central Adiposity ◽  
Cross Sectional ◽  
Arterial Blood

Whereas truncal (central) adiposity is strongly associated with the insulin resistant metabolic syndrome, it is uncertain whether this is accounted for principally by visceral adiposity (VAT). Several recent studies find as strong or stronger association between subcutaneous abdominal adiposity (SAT) and insulin resistance. To reexamine the issue of truncal adipose tissue depots, we performed cross-sectional abdominal computed tomography, and we undertook the novel approach of partitioning SAT into the plane superficial to the fascia within subcutaneous adipose tissue (superficial SAT) and that below this fascia (deep SAT), as well as measurement of VAT. Among 47 lean and obese glucose-tolerant men and women, insulin-stimulated glucose utilization, measured by euglycemic clamp, was strongly correlated with both VAT and deep SAT ( r = −0.61 and −0.64, respectively; both P < 0.001), but not with superficial SAT ( r = −0.29, not significant). Also, VAT and deep SAT followed a highly congruent pattern of associations with glucose and insulin area under the curve (75-g oral glucose tolerance test), mean arterial blood pressure, apoprotein-B, high-density lipoprotein cholesterol, and triglyceride. Superficial SAT had markedly weaker association with all these parameters and instead followed the pattern observed for thigh subcutaneous adiposity. We conclude that there are two functionally distinct compartments of adipose tissue within abdominal subcutaneous fat and that the deep SAT has a strong relation to insulin resistance.

scholarly journals Relationship of obesity to adipose tissue insulin resistance

2020 ◽  
Vol 8 (1) ◽  
pp. e000741 ◽  
Author(s):  
Jiajia Jiang ◽  
Xueli Cai ◽  
Yuesong Pan ◽  
Xiaoyan Du ◽  
Huiping Zhu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Adipose Tissue ◽  
Metabolic Diseases ◽  
Population Attributable Risk ◽  
Area Under The Curve ◽  
Insulin Level ◽  
Diagnostic Value ◽  
Attributable Risk ◽  
Cross Sectional ◽  
Associated Factor

AimsThis study aimed to examine the association of different anatomical forms of obesity with adipose tissue insulin resistance and to assess the diagnostic value and contribution of obesity to adipose tissue insulin resistance.MethodsThis cross-sectional study included a total of 499 subjects aged 50 years or over. Multivariate regression analysis was conducted to clarify the association of different forms of obesity with adipose tissue insulin resistance (calculated as fasting insulin level×fasting free fatty acids level). Receiver operating characteristic cure analyses were used to assess the diagnostic value of each anthropometric indicator for adipose tissue insulin resistance. Attributable risk per cent and population attributable risk per cent were calculated to assess the contribution of obesity to adipose tissue insulin resistance.ResultsAfter adjustment for potential confounders, we showed that anthropometric indicators were all positively associated with adipose tissue insulin resistance. In males, waist circumference (WC) was the strongest associated factor (OR, 3.43 (95% CI 2.03 to 5.82)) and indicator (area under the curve (AUC): 0.79) of adipose tissue insulin resistance among those indicators. Here, abdominal obesity (WC≥90 cm) accounted for 64.9% of adipose tissue insulin resistance in the abdominal obese males. Accordingly, body mass index (BMI) was the strongest associated factor (OR,3.08 (95% CI 2.04 to 4.66)) and indicator (AUC: 0.78) of adipose tissue insulin resistance in females. Here, general obesity of BMI≥25 kg/m2 accounted for 66.2% of the adipose tissue insulin resistance in the general obese females. We further demonstrated that adipose tissue insulin resistance was associated or trended to be associated with the metabolic diseases of cardiovascular disease, type 2 diabetes and fatty liver in subjects with normal BMI and WC.ConclusionsMaintaining WC in males and BMI in females to a normal range could be an important strategy to significantly reduce the occurrence of adipose tissue insulin resistance and the subsequent metabolic diseases.

scholarly journals Insulin Resistance Diagnosed by HOMA-IR may be Overestimated in Adults with Greater Fat-Free Mass: The ELSA-Brasil Study

2020 ◽  
Author(s):  
Divanei Zaniqueli ◽  
Rafael de Oliveira Alvim ◽  
Rosane Harter Griep ◽  
Isabela Martins Benseñor ◽  
Sandhi Maria Barreto ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Fat ◽  
Bioelectrical Impedance ◽  
Tolerance Test ◽  
Fat Free Mass ◽  
Percent Body Fat ◽  
Oral Glucose ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Cross Sectional

Abstract Background Conflicting results have been reported on the association of fat-free mass (FFM) and insulin resistance (IR). The way of indexing FFM may be a bias. This study sought to test the association of FFM and IR after indexing FFM to avoid collinearity. Methods This cross-sectional study comprised 11,284 volunteers, ages 38-79 years. Body composition was assessed by multi-frequency bioelectrical impedance. FFM indexed to body surface area (FFMbsa) was calculated. Excess body fat was assigned to individuals with percent body fat ≥ 85th percentile for age and sex. Fasting insulin and glucose, and 2h glucose in the oral glucose tolerance test were obtained. Homeostasis model assessment-insulin resistance (HOMA-IR) > 3.0 was set as the cut-off for IR.Results Percent body fat decreased from the 1st to the 5th quintile of FFMbsa in both women (Eta 2 = 0.166) and men (Eta 2 = 0.133). In women, fasting insulin (Eta 2 = 0.002), glucose (Eta 2 = 0.006), and HOMA-IR (Eta 2 = 0.007) increased slightly, whereas 2h glucose did not change towards the highest quintile of FFMbsa. In men, fasting insulin and HOMA-IR were similar across the quintiles of FFMbsa, whereas fasting glucose increased slightly (Eta 2 = 0.002) and 2h glucose decreased (Eta 2 = 0.005) towards the highest quintile of FFMbsa. Greater FFMbsa explained 1.8% of the odds of IR among women and 0.9% among men.Conclusion The lack of association of FFM and 2h glucose contrasted with greater odds of IR (by HOMA-IR) associated with greater FFM. The association of greater FFM and IR may be overestimated when the diagnosis is provided by HOMA-IR.

Association between insulin resistance and cardinal rheological parameters in young healthy Japanese individuals during 75 g oral glucose tolerance test

2021 ◽  
Vol 21 ◽  
Author(s):  
Larasati Martha ◽  
Takao Kimura ◽  
Akihiro Yoshida ◽  
Katsuhiko Tsunekawa ◽  
Tomoyuki Aoki ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Platelet Count ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Rheological Parameters ◽  
Oral Glucose ◽  
Insulinogenic Index ◽  
Model Assessment ◽  
Matsuda Index ◽  
Wbc Count

Background: Insulin resistance is a well-known predictor and risk factor for Type 2 Diabetes Mellitus (T2DM). Higher hematocrit induced by higher insulin resistance affects blood rheology. Objective: This study intended to reveal the association between indices of insulin resistance and hemorheological parameters during a 75 g oral glucose tolerance test (75-g OGTT). Methods: A total of 575 healthy young Japanese participants took 75-g OGTT. We then analyzed the association between insulin resistance indices and hematological parameters. Results: The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was significantly correlated with hematocrit (Ht), hemoglobin (Hb), Red Blood Cell (RBC), White Blood Cell (WBC), platelet count, lipid parameters, and Body Mass Index (BMI). The Matsuda index was negatively correlated with RBC count, WBC count, platelet count, Total Cholesterol (TC), Low-Density Lipoprotein-Cholesterol (LDL-C), triglyceride (TG), and positively correlated with High-Density Lipoprotein-Cholesterol (HDL-C). The disposition index was negatively correlated with Hb, RBC count, LDL-C, and BMI, while remaining positively correlated with HDL-C. The Homeostasis Model Assessment of beta cell (HOMA- IR ) was positively correlated with WBC count, platelet count, TC, LDL-C, and TG. The insulinogenic index was positively correlated with WBC count, platelet count, and TC. Multiple regression analysis revealed that HOMA-IR was independently associated with TG, and the Matsuda index was independently associated with TG, WBC count, and platelet count. The insulinogenic index was independently associated with WBC count. Conclusion: Cardinal rheological parameters reflected insulin resistance and were released even in the young, healthy Japanese individuals within the physiological range of glycemic control.

scholarly journals Lifetime congenital isolated GH deficiency does not protect from the development of diabetes

2013 ◽  
Vol 2 (2) ◽  
pp. 112-117 ◽  
Author(s):  
Taísa A R Vicente ◽  
Ívina E S Rocha ◽  
Roberto Salvatori ◽  
Carla R P Oliveira ◽  
Rossana M C Pereira ◽  
...  
Keyword(s):  
Glucose Tolerance ◽  
Cell Function ◽  
Gh Deficiency ◽  
Receptor Gene ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Insulinogenic Index ◽  
Model Assessment ◽  
Cross Sectional

ObjectivesAdult subjects with untreated, lifetime, isolated GH deficiency (IGHD) due to a homozygous GHRH receptor gene mutation (MUT/MUT) residing in Itabaianinha, Brazil, present with lower BMI, higher prevalence of impaired glucose tolerance (IGT), increased insulin sensitivity (IS), and reduced β-cell function (βCF) when compared with non-BMI-matched homozygous normal controls. However, the prevalence of diabetes mellitus (DM) in this cohort is unknown. Comparing their IS and βCF with BMI-matched individuals heterozygous for the same mutation (MUT/N) may be useful to elucidate the role of the GH–IGF1 axis in IS and βCF. The purposes of this work were to verify the prevalence of IGT and DM in adult MUT/MUT subjects from this kindred and to compare IS and βCF in MUT/MUT and MUT/N.DesignCross-sectional study.MethodsWe studied most (51) of the living IGHD adults of this kindred who are GH naive. The oral glucose tolerance test (OGTT) could be performed in 34 subjects, fasting glucose was measured in 15, while two had a previous diagnosis of DM. The OGTT results of 24 MUT/MUT subjects were compared with those of 25 BMI-matched MUT/N subjects. IS was assessed by homeostatic model assessment of insulin resistance (HOMA–IR), quantitative IS check index, and oral glucose IS index for 2 and 3 h. βCF was assayed by HOMA-β, insulinogenic index, and the area under the curve of insulin:glucose ratio.ResultsThe prevalence of DM and IGT in IGHD was 15.68 and 38.23% respectively. IS was increased and βCF was reduced in MUT/MUT in comparison with MUT/N.ConclusionsLifetime, untreated IGHD increases IS, impairs βCF, and does not provide protection from diabetes.

Decreased Circulating MANF in Women with PCOS is Elevated by Metformin Therapy and is Inversely Correlated with Insulin Resistance and Hyperandrogenism

2020 ◽  
Vol 52 (02) ◽  
pp. 109-116
Author(s):  
Jie Wei ◽  
Cong Wang ◽  
Gangyi Yang ◽  
Yanjun Jia ◽  
Yang Li ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Neurotrophic Factor ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Model Assessment ◽  
Metformin Treatment ◽  
Fat Percentage ◽  
Cross Sectional ◽  
Metformin Therapy

AbstractMesencephalic astrocyte-derived neurotrophic factor (MANF) is a novel neurotrophic factor. Although recent studies have suggested that MANF appeared to be associated with insulin resistance, the results have been inconsistent. The aim of our study was to determine the serum MANF levels in women with PCOS and controls, to investigate their relationship to insulin resistance, and to evaluate circulating MANF changes with metformin intervention in PCOS women. We conducted a series of cross-sectional and interventional studies in 90 newly diagnosed patients with PCOS and 60 age- and gender-matched controls. Oral glucose tolerance test and euglycemic-hyperinsulinemic clamps were performed to assess the glucose tolerance and insulin sensitivity. Forty-three women with PCOS were randomly assigned to six months of oral metformin therapy. Serum MANF levels were significantly lower in women with PCOS than in controls. Serum MANF levels were positively correlated with M-value and negatively correlated with body mass index (BMI), body fat percentage (FAT), homeostatic model assessment of insulin resistance (HOMA-IR), and free androgen index (FAI). Multivariate stepwise regression demonstrated that serum MANF levels were independently associated with M-value and FAI. After six months of metformin treatment, there was a significant increase in serum MANF levels in PCOS women. Serum MANF levels are decreased in women with PCOS, and are reversely related to insulin resistance and hyperandrogenism. Metformin treatment elevates serum MANF levels and alleviates insulin resistance and hyperandrogenism in PCOS women.

scholarly journals Serum apoA1 (Apolipoprotein A-1), Insulin Resistance, and the Risk of Gestational Diabetes Mellitus in Human Pregnancy—Brief Report

2019 ◽  
Vol 39 (10) ◽  
pp. 2192-2197 ◽  
Author(s):  
Ravi Retnakaran ◽  
Chang Ye ◽  
Philip W. Connelly ◽  
Anthony J. Hanley ◽  
Mathew Sermer ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Cell Function ◽  
Density Lipoprotein ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Model Assessment ◽  
Human Pregnancy ◽  
Matsuda Index ◽  
Β Cell Function

Objective: apoA1 (apolipoprotein A-1) is the main lipoprotein associated with HDL (high-density lipoprotein) cholesterol. It was recently reported that intravenous infusion of apoA1 could lower insulin resistance in pregnant rats, leading to the suggestion that apoA1 could provide a target for reducing pregnancy-induced insulin resistance and the risk of gestational diabetes mellitus (GDM) in humans. However, the effects of apoA1 on insulin resistance and risk of GDM in human pregnancy are not known. Thus, we sought to systematically evaluate the relationships of apoA1 with glucose homeostasis and metabolic function in pregnant women. Approach and Results: In this study, 870 pregnant women were recruited in late second trimester and underwent metabolic characterization, including an oral glucose tolerance test on which 214 were diagnosed with GDM. Metabolic characterization included assessment of glucose tolerance, insulin sensitivity/resistance (Matsuda index, homeostasis model assessment of insulin resistance), pancreatic β-cell function, lipids (LDL [low-density lipoprotein] cholesterol, HDL cholesterol, triglycerides, apoB [apolipoprotein B], and apoA1), CRP (C-reactive protein), and adiponectin. Serum apoA1 was strongly correlated with HDL (r=0.79, P <0.0001) and weakly so with adiponectin (r=0.12, P =0.0004) but showed no association with measures of insulin sensitivity/resistance, β-cell function, glycemia, or CRP. There were no significant differences across apoA1 tertiles in mean adjusted Matsuda index ( P =0.24), homeostasis model assessment of insulin resistance ( P =0.08), or area under the glucose curve on the oral glucose tolerance test ( P =0.96). Moreover, there were no differences in risk of GDM across tertiles of apoA1, both before ( P =0.67) and after covariate adjustment ( P =0.78). Conclusions: Serum apoA1 is not associated with insulin resistance or the risk of GDM in human pregnancy.

scholarly journals Regional and Overall Aortic Function In Nondiabetic Individuals With Insulin Resistance and Normal Glucose Tolerance

2013 ◽  
Vol 98 (11) ◽  
pp. 4457-4463 ◽  
Author(s):  
Dimitrios A. Stakos ◽  
Konstantinos D. Boudoulas ◽  
Trudy R. Gaillard ◽  
Dara P. Schuster ◽  
Kwame Osei ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Glucose Tolerance ◽  
Vascular Function ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Stiffness Index ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Cross Sectional ◽  
Over Time

Context: Insulin resistance is associated with altered vascular function in diabetes. Objective: The objective of the study was to define the overall and regional aortic function as well as the changes of aortic function over time in nondiabetic individuals with insulin resistance and a normal oral glucose tolerance test (OGTT). Design: This was a cross-sectional and longitudinal analysis with 12 months follow-up. Setting: The setting of the study was in primary care. Patients: Nondiabetic individuals (n = 181, mean age 42 ± 8 y) with a normal OGTT and insulin resistance as defined by the insulin sensitivity index (ISI) participated in the study. Interventions: ISI was estimated from serial measurements of plasma insulin and glucose during an iv glucose tolerance test. Ascending and abdominal aortic distensibility (AoD) and stiffness index-β (AoSI) were assessed using echocardiography. Carotid-to-femoral artery pulse wave velocity (PWVc-f; an index of overall aortic function) was measured from carotid and femoral arteries Doppler flow velocities recorded simultaneously with an electrocardiogram. Associations between ISI, AoD, AoSI, and PWVc-f were assessed using linear regression analyses and ANOVA. Differences between baseline and 12 months were compared using a paired t test. Main Outcome Measures: AoD and AoSI associations as well as changes over a 12-month period in relation to ISI were measured. Results: Ascending AoD (P = .01) and ascending AoSI (P = .025) were significantly associated with ISI; in contrast, abdominal AoD and AoSI and PWVc-f did not. Changes in AoD, AoSI, and PWVc-f over time were more prominent in individuals with low ISI compared with those with high ISI. Conclusions: The significant associations between ISI and aortic function suggest that insulin resistance may affect the cardiovascular system, even when OGTT is normal.

scholarly journals Intergenerational Metabolomic Analysis of Mothers with a History of Gestational Diabetes Mellitus and Their Offspring

2020 ◽  
Vol 21 (24) ◽  
pp. 9647
Author(s):  
Raffael Ott ◽  
Xenia Pawlow ◽  
Andreas Weiß ◽  
Anna Hofelich ◽  
Melanie Herbst ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Graphical Models ◽  
Area Under The Curve ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Sensitivity Index ◽  
Cross Sectional

Shared metabolomic patterns at delivery have been suggested to underlie the mother-to-child transmission of adverse metabolic health. This study aimed to investigate whether mothers with gestational diabetes mellitus (GDM) and their offspring show similar metabolomic patterns several years postpartum. Targeted metabolomics (including 137 metabolites) was performed in plasma samples obtained during an oral glucose tolerance test from 48 mothers with GDM and their offspring at a cross-sectional study visit 8 years after delivery. Partial Pearson’s correlations between the area under the curve (AUC) of maternal and offspring metabolites were calculated, yielding so-called Gaussian graphical models. Spearman’s correlations were applied to investigate correlations of body mass index (BMI), Matsuda insulin sensitivity index (ISI-M), dietary intake, and physical activity between generations, and correlations of metabolite AUCs with lifestyle variables. This study revealed that BMI, ISI-M, and the AUC of six metabolites (carnitine, taurine, proline, SM(-OH) C14:1, creatinine, and PC ae C34:3) were significantly correlated between mothers and offspring several years postpartum. Intergenerational metabolite correlations were independent of shared BMI, ISI-M, age, sex, and all other metabolites. Furthermore, creatinine was correlated with physical activity in mothers. This study suggests that there is long-term metabolic programming in the offspring of mothers with GDM and informs us about targets that could be addressed by future intervention studies.

scholarly journals High DPP-4 Concentrations in Adolescents Are Associated With Low Intact GLP-1

2018 ◽  
Vol 103 (8) ◽  
pp. 2958-2966 ◽  
Author(s):  
Rasmus Stenlid ◽  
Hannes Manell ◽  
Maria Halldin ◽  
Joel Kullberg ◽  
Håkan Ahlström ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Glucose Tolerance ◽  
Plasma Concentrations ◽  
Tolerance Test ◽  
High Plasma ◽  
University Hospital ◽  
Liver Fat ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Dipeptidyl Peptidase 4

Abstract Context Dipeptidyl peptidase 4 (DPP-4) metabolizes glucagon-like peptide-1 (GLP-1), and increased DPP4 levels are associated with obesity and visceral adiposity in adults. Objective Investigating DPP-4 levels in adolescents and their association with (1) circulating intact GLP-1 levels and glucose tolerance; (2) body mass index (BMI); and (3) visceral, subcutaneous, and liver fat compartments. Design Cross-sectional study, July 2012 to April 2015. Setting Pediatric obesity clinic, Uppsala University Hospital. Patients and Participants Children and adolescents with obesity (n = 59) and lean controls (n = 21) aged 8 to 18 years. Main Outcome Measures BMI SD score, fasting plasma concentrations of DPP-4, total and intact GLP-1, fasting and oral glucose tolerance test (OGTT) concentrations of glucose, and visceral adipose tissue (VAT) and subcutaneous adipose tissue volumes and liver fat fraction. Results Plasma DPP-4 levels decreased with age in both obese (41 ng/mL per year) and lean subjects (48 ng/mL per year). Plasma DPP-4 levels were higher in males in both the obesity and lean groups. With adjustments for age and sex, plasma DPP-4 level was negatively associated with intact GLP-1 at fasting (β = −12.3; 95% CI: −22.9, −1.8) and during OGTT (β = −12.1; 95% CI: −22.5, −1.7). No associations were found between DPP-4 and plasma glucose levels measured at fasting or after a 2-hour OGTT. Plasma DPP-4 level was 19% higher in obese subjects. Among adipose tissue compartments, the strongest association was with VAT (β = 0.05; 95% CI: −0.02, 0.12). Conclusions In adolescents, high plasma DPP-4 concentrations were associated with low proportions of intact GLP-1, high BMI, young age, and male sex. The observed associations are compatible with increased metabolism of GLP-1 in childhood obesity.

scholarly journals Hepatic Insulin Extraction in NAFLD Is Related to Insulin Resistance Rather Than Liver Fat Content

2018 ◽  
Vol 104 (5) ◽  
pp. 1855-1865 ◽  
Author(s):  
Kristina M Utzschneider ◽  
Steven E Kahn ◽  
David C Polidori
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Body Fat ◽  
Subcutaneous Fat ◽  
Insulin Clearance ◽  
Liver Fat ◽  
Glucose Disposal ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Hepatic Insulin Extraction

Abstract Context Total insulin clearance is decreased in nonalcoholic fatty liver disease (NAFLD), but the relationship between liver fat and hepatic insulin extraction (HIE) is unknown. Objective This cross-sectional study addresses the hypothesis that HIE is reduced in NAFLD and investigates metabolic and/or anthropometric characteristics most closely associated with insulin clearance. Participants Nondiabetic subjects with NAFLD (n = 13) and age- and body mass index (BMI)-matched controls with normal liver enzymes (n = 15) underwent abdominal CT, dual-energy X-ray absorptiometry, oral glucose tolerance test (OGTT), and labeled two-step hyperinsulinemic-euglycemic clamps. Outcome Measurements Liver fat was estimated by the CT liver/spleen ratio. Hepatic and extrahepatic insulin clearances were modeled using clamp and OGTT data. Results Extrahepatic insulin clearance and HIE were not different between NAFLD and controls and did not correlate with liver fat. HIE was positively correlated with insulin sensitivity [rate of glucose disposal (Rd; low r = +0.7, P &lt; 0.001; high r = +0.6, P = 0.001), adiponectin (r = +0.55, P = 0.004), and insulin-mediated suppression of clamp nonesterified free fatty acid (NEFA; r = +0.67, P &lt; 0.001)] but was not associated with fasting NEFA, insulin-mediated suppression of glucose production, or measures of adiposity. Extrahepatic insulin clearance was positively associated with percent body fat (r = +0.44, P = 0.02) and subcutaneous fat (r = +0.42, P = 0.03) but not BMI, intra-abdominal fat, liver fat, Rd, adiponectin, or NEFA. Conclusions HIE is not directly associated with hepatic steatosis but is associated with muscle and adipose tissue insulin resistance. The data suggest differential regulation of insulin clearance with extrahepatic insulin clearance being associated with body fat and not insulin sensitivity.

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