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Association of visceral and subcutaneous fat with glucose intolerance, insulin resistance, adipocytokines and inflammatory markers in Asian Indians (CURES-113)
Authors:Indulekha Karunakaran  Anjana Ranjith Mohan  Surendar Jayagopi  Mohan Viswanathan
Affiliation:aMadras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, International Diabetes Federation (IDF) Centre for Education, Gopalapuram, Chennai, 600 086, India
Abstract:

Objectives:

The aim of the study was to assess the association between visceral and subcutaneous fat with glucose intolerance, adipocytokines, inflammatory markers and carotid IMT in Asian Indians.

Design and methods:

Subjects with NGT (n = 85), IGT (n = 49) and T2DM (n = 93) were randomly selected from CURES. Total abdominal, visceral and subcutaneous fat were measured using Helical CT scan. Adiponectin, hs-CRP, TNF-alpha, oxidized LDL, visfatin and leptin and IMT and insulin resistance were assessed.

Results:

Total abdominal fat (p = 0.041) and the visceral fat (p = 0.039) but not subcutaneous fat progressively increased from NGT, IGT and T2DM subjects. With increasing quartiles of visceral fat, there was a significant increase in insulin resistance (p = 0.040); significant decrease in adiponectin (p = 0.043) and increase in TNF-alpha (p = 0.028), hs-CRP (p = 0.043), OX-LDL (p = 0.034) and visfatin (p = 0.040), and carotid IMT (p = 0.047) was observed.

Conclusion:

Visceral fat levels increased with increasing glucose intolerance and are associated with decreased levels of adiponectin and increased levels of hs-CRP, TNF-alpha, oxidized LDL, visfatin, HOMA-IR and IMT.
Keywords:Abbreviations: NGT, normal glucose tolerance   IGT, impaired glucose tolerance   T2DM, type 2 diabetes mellitus   CAD, coronary artery disease   CURES, Chennai Urban Rural Epidemiology Study   HOMA-IR, homeostasis model assessment of insulin resistance   IMT, intimal media thickness   CT, computed tomography   TNF-alpha, tumor necrosis factor alpha   Oxidized LDL, oxidized low density lipoproptein   ELISA, enzyme-linked immunosorbent assay   hs-CRP, high sensitive C-reactive protein   BMI, body mass index   FPG, fasting plasma glucose   WHO, World Health Organization   ANOVA, analysis of variance   FFA, free fatty acid   SECURE, Study to Evaluate Carotid Ultrasound changes in patients treated with Ramipril and vitamin E   GRACE study, Gender, Race and Clinical Experience study   HDL-C, high density lipoprotein cholesterol   LDL-C, low density lipoprotein cholesterol   HbA1c, glycosylated hemoglobin   SPSS, Statistical Package for Social Sciences   SD, standard deviation   IRS, insulin receptor substrate   TG, triglyceride   IR, insulin resistance   PIVUS, Prospective Study of the Vasculature in Uppsala Seniors
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