SEPARATE ASSOCIATIONS BETWEEN VISCERAL AND SUBCUTANEOUS ADIPOSE-TISSUE DISTRIBUTION, INSULIN AND GLUCOSE-LEVELS IN OBESE WOMEN

OBJECTIVE - The primary purpose of this study was to determine the sep arate associations between visceral (VAT) and subcutaneous adipose tis sue (SAT) distribution, skeletal muscle (SM), and plasma insulin and g lucose levels, and. A second objective was to determine whether anthro pometric methods could be used to identify those women who are at incr eased metabolic risk. RESEARCH DESIGN AND METHODS - Whole-body SAT, SM , and VAT volume were measured (in liters), using a multislice magneti c resonance imaging (MRI) protocol in 40 premenopausal obese women. Pl asma insulin and glucose levels were measured after an overnight fast and in response to a 75-g oral glucose tolerance test (OGTT). RESULTS - With the exception of fasting glucose, VAT was positively correlated with all insulin and glucose variables (P < 0.01). This observation r emained true whether VAT was derived from multiple MR images (i.e., VA T volume [in liters]) or from a single MR image (i.e., VAT area [in sq uared centimeters]). Furthermore, the segmentation of intraperitoneal adipose tissue (portally drained adipose tissue) from VAT did not impr ove the observed relationships. VAT remained a significant (P < 0.05) correlate of insulin and glucose area after adjusting for either SAT o r abdominal SAT (ASAT). SAT, ASAT, and SM volume were not related to a ny metabolic variable. Waist circumference (WC) was the single stronge st anthropometric correlate for fasting insulin and insulin area (P < 0.05). Because it has been reported that disturbances in insulin-gluco se homeostasis are more likely associated with a WC value >1 m, in sub jects matched for total adiposity, we compared the glucose and insulin area values for those with a WC above (n = 17) and below (n = 15) thi s value. The group with a WC >1 m had significantly higher values for both insulin and glucose areas (P < 0.05).CONCLUSIONS - The primary ob servation is that VAT is associated with plasma insulin and glucose va riables independent of whole-body SAT, ASAT, and SM in obese women. In addition, the findings provide support for the utility of WC as an an thropometric tool that may be used to identify a subgroup of obese pat ients at increased metabolic risk.