Deterioration of the metabolic risk profile in women - Respective contributions of impaired glucose tolerance and visceral fat accumulation

OBJECTIVE - To determine whether the impaired glucose tolerance (IGT) state contributes to the deterioration of the metabolic profile in women after t aking into account the contribution of visceral adipose tissue (AT) accumul ation, as measured by computed tomography. RESEARCH DESIGN AND METHODS - We studied 203 women with normal glucose tole rance (NGT) and 46 women with IGT, defined as a glycemia between 7.8 and 11 .1 mmol/l measured 2 h after a 75-g oral glucose load. RESULTS - Women with IGT were characterized by a higher visceral AT accumul ation and by higher concentrations of fasting plasma glucose, insulin, and C-peptide as well as by higher Plasma concentrations of cholesterol. trigly cerides, and apolipoprotein B (apoB) and by greater cholesterol-to-HDL-chol esterol ratio, reduced LDL peak particle size, lower HDL-cholesterol anti H DL-cholesterol concentrations, and higher blood pressure (P < 0.01) than wo men with NGT. When we matched 27 pairs of women for visceral At and fat mas s as well as fur menopausal status. differences previously found in LDL-cho lesterol, IDL peak particle size, HDL cholesterol, and HDL2-cholesterol con centrations as well as in the cholesterol-to-HDL-cholesterol ratio and bloo d pressure were eliminated, whereas triglyceride concentrations remained si gnificantly higher in women with IGT CONCLUSIONS - A high visceral AT accumulation is a major factor involved in the deterioration of many metabolic variables in women with IGT, with the notable exception of triglyceride concentrations. which remained significan tly different between women with NGT and women with IGT after adjustment fo r visceral fat.