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Cited by 289Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesCardiovascular Disease and Adiposity

Metabolic Effects of Visceral Fat Accumulation in Type 2 Diabetes

Gastaldelli, Amalia, Miyazaki, Yoshinori, Pettiti, Maura, Matsuda, Masafumi, Mahankali, Srihanth, Santini, Eleonora, DeFronzo, Ralph A., Ferrannini, Ele·2002·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2002-020696
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Abstract

Visceral fat (VF) excess has been associated with decreased peripheral insulin sensitivity and has been suggested to contribute to hepatic insulin resistance. However, the mechanisms by which VF impacts on hepatic glucose metabolism and the quantitative role of VF in glycemic control have not been investigated. In the present study 63 type 2 diabetic subjects (age, 55 +/- 1 yr; fasting plasma glucose, 5.5-14.4 mmol/liter; hemoglobin A(1c), 6.1-11.7%) underwent measurement of 1) fat-free mass ((3)H(2)O technique), 2) sc and visceral abdominal fat area (magnetic resonance imaging), 3) insulin sensitivity (euglycemic insulin clamp), 4) endogenous glucose output ([(3)H]glucose infusion technique), and 5) gluconeogenesis ((2)H(2)O method). After adjustment for sex, age, body mass index, diabetes duration, ethnicity, and sc fat area, VF area was positively related to fasting hyperglycemia (partial r = 0.46; P = 0.001) as well as to hemoglobin A(1c) (partial r = 0.50; P = 0.0003). Insulin sensitivity was reciprocally related to VF independently of body mass index (partial r = 0.33; P = 0.01). In contrast, the relation of basal endogenous glucose output to VF was not statistically significant. This lack of association was explained by the fact that VF was positively associated with gluconeogenesis flux (confounder-adjusted, partial r = 0.45; P = 0.003), but was reciprocally associated with glycogenolysis (partial r = 0.31; P < 0.05). We conclude that in patients with established type 2 diabetes, VF accumulation has a significant negative impact on glycemic control through a decrease in peripheral insulin sensitivity and an enhancement of gluconeogenesis.

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  • The commonly observed relationship between increased VAT and metabolic disease is because of the correlation between VAT and IHTG.

    “and suggest the commonly observed relationship between increased VAT and metabolic disease (1-4) is because of the correlation between VAT and IHTG (8)(9)(10).”

    From Intrahepatic fat, not visceral fat, is linked with metabolic complications of obesity (2009) · cites this paper as [1]

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Authors
Gastaldelli, A., Miyazaki, Y., Pettiti, M., Matsuda, M., Mahankali, S., Santini, E., DeFronzo, R. A., & Ferrannini, E.
Affiliations
  • University of Pisa (IT)
  • The University of Texas at San Antonio Health Science Center (US)
Corresponding author
Ferrannini, Ele
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2002-11
Volume
87
Issue
11
Pages
5098-5103
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2002-020696
OpenAlex
W1978270587
Cited by
289
References
33
Citations by year
2026: 6 · 2025: 16 · 2024: 10 · 2023: 18 · 2022: 14 · 2021: 13 · 2020: 11 · 2019: 19 · 2018: 7 · 2017: 6 · 2016: 15 · 2015: 11 · 2014: 12 · 2013: 19 · 2012: 12
FWCI
5.13
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK 24092)
  • National Center for Research Resources (M01RR01346, M01RR001346)
  • NIH Clinical Center
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Keywords
visceral fat, type 2 diabetes, insulin sensitivity, hepatic insulin resistance, gluconeogenesis, glycogenolysis, glycemic control, hyperglycemia, abdominal fat
MeSH terms
Adipose Tissue, Blood Glucose, Body Composition, Body Constitution, Deuterium, Diabetes Mellitus, Type 2, Fasting, Fatty Acids, Nonesterified, Female, Gluconeogenesis, Glucose, Glycated Hemoglobin, Humans, Hyperglycemia, Insulin Resistance, Liver, Magnetic Resonance Imaging, Male, Middle Aged, Regression Analysis, Tritium, Viscera, Glucose Clamp Technique, Body Mass Index

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