VISCERAL ADIPOSITY, FASTING PLASMA-INSULIN, AND BLOOD-PRESSURE IN JAPANESE-AMERICANS

OBJECTIVE- To examine the associations among blood pressure, body mass index (BMI), intra-abdominal fat, and lasting plasma insulin levels a mong nondiabetic subjects. RESEARCH DESIGN AND METHODS- Second- (Nisei , n = 290) and third- (Sansei, n = 230) generation Japanese-American s ubjects without non-insulin-dependent diabetes mellitus (NIDDM) were s elected from a community-based study of NIDDM incidence and complicati ons. A cross-sectional comparison of measures obtained at the baseline visit was performed. Intra-abdominal fat (IAF) area was assessed usin g computed tomography. Associations among blood pressure, fasting insu lin, and adiposity measures were assessed by comparison of mean values and multiple linear regression analysis. RESULTS- Hypertensive men an d women had significantly higher mean IAF areas. Fasting insulin level s were somewhat higher in hypertensive subjects, with the only signifi cant difference occurring among Sansei men. Both systolic and diastoli c blood pressure correlated more strongly with IAF than BMI or skinfol d thicknesses among Nisei, whereas among Sansei, IAF and BMI correlate d equally well with either blood pressure. Significant positive correl ations were found between fasting insulin level and blood pressure amo ng Sansei only, even after adjustment for IAF and BMI (diastolic blood pressure - insulin coefficient = 0.24, P = 0.0043; systolic blood pre ssure - insulin coefficient = 0.36, P = 0.0025). CONCLUSIONS- IAF corr elated more strongly with blood pressure than BMI or skinfold thicknes ses among older, second-generation Japanese-Americans and was positive ly correlated with blood pressure among Sansei independent of fasting insulin level. Fasting insulin was significantly correlated with blood pressure independent of visceral and overall adiposity among third-ge neration Japanese-Americans.