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Metabolic Effects of Visceral Fat Accumulation in Type 2 Diabetes
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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“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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Metadata
- 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
- 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
- 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 › Endocrinology, Diabetes and Metabolism › 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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