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Evaluation of Abdominal Fat Distribution in Noninsulin-Dependent Diabetes Mellitus: Relationship to Insulin Resistance¹

Service de Diabétologie et d’Hormonologie et Service de Radiologie, Hôpital Saint-Louis, 75475 Paris Cedex 10, France; and IMASSA, Centre d’Essais en Vol, Département de Physiologie Systémique, 91223 Bretigny sur Orge, France

Address all correspondence and requests for reprints to: Dr. Jean-François Gautier, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 4212 North 16th Street, Phoenix, Arizona 85016.

Abstract

Accumulation of visceral adipose tissue is associated with metabolic complications such as noninsulin-dependent diabetes mellitus. The aim of this study was to evaluate the effect of abdominal adipose tissue on insulin sensitivity in subjects with noninsulin-dependent diabetes mellitus (NIDDM). Areas of abdominal fat were calculated from axial magnetic resonance images obtained at the level of the umbilicus in 21 men with NIDDM [age, 45.6 ± 8.3 (±SD) yr; body mass index, 29.3 ± 4.5 kg/m^-2; total body fat (skinfold thickness), 26.8 ± 5.4%; waist to hip ratio, 0.97 ± 0.07; duration of diabetes, 59 ± 47 months; hemoglobin A_1c, 8.1 ± 1.5%]. Insulin sensitivity was evaluated by an insulin tolerance test. The areas of deep abdominal fat and sc abdominal fat were, respectively, 135.3 ± 55.1 and 211.8 ± 99.1 cm². The blood glucose disappearance rate was 2.11 ± 0.87%/min and was negatively related to deep abdominal fat (r = 0.72; P = 0.0025). In contrast, areas of sc abdominal fat, total body fat, body mass index, and waist to hip ratio were not related to the blood glucose disappearance rate. Plasma triglyceride concentrations averaged 1.8 ± 0.8 mmol/L and were positively related to deep abdominal fat (r = 0.69; P = 0.0018). We conclude that insulin sensitivity is strongly related to visceral adipose tissue accumulation in NIDDM.

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