Contribution of visceral obesity to the deterioration of the metabolic risk profile in men with impaired glucose tolerance

Aims/hypothesis. Impaired glucose tolerance is associated with metabolic al terations which increase car diovascular disease risk. The contribution of hyperglycaemia to this increased risk is, however, not clear. Abdominal obe sity is often observed in subjects with impaired glucose tolerance; our obj ective was therefore to find the contribution of visceral adipose tissue to the deterioration of the metabolic risk profile noted in subjects with imp aired glucose tolerance. Methods. We studied 284 men with a normal glucose tolerance and 66 men with impaired glucose tolerance which was defined as a glycaemia between 7.8 an d 11.1 mmol/l 2 h after a 75-g glucose load. Results. Men with impaired glucose tolerance had more visceral adipose tiss ue and higher concentrations of plasma glucose and insulin in the fasting s tate and following a 75-g oral glucose load than men with a normal glucose tolerance. They also had higher concentrations of plasma cholesterol, trigl ycerides, apolipoprotein B and lower concentrations of HDL-cholesterol as w ell as higher cholesterol:HDL-cholesterol ratios than men with a normal glu cose tolerance. The two groups of men were then compared after a statistica l adjustment for the amount of visceral adipose tissue. Although men with i mpaired glucose tolerance still had higher Easting plasma glucose and insul in concentrations after the adjustment for visceral adipose tissue, differe nces in all the variables of the lipid-lipoprotein profile were eliminated. Conclusion/interpretation. Visceral adipose tissue accumulation is an impor tant factor in the deterioration of the plasma lipid-lipoprotein noted in m en with impaired glucose tolerance.