Preferential fat deposition in subcutaneous versus visceral depots is associated with insulin sensitivity
Open accessAbstract
BACKGROUND: Studies on the relationship between regional fat and insulin resistance yield mixed results. Our objective was to determine whether regional fat distribution, independent of obesity, is associated with insulin resistance. DESIGN: Subjects included 115 healthy, overweight/moderately obese adults with body mass index (BMI) 25-36.9 kg/m(2) who met predetermined criteria for being insulin resistant (IR) or insulin sensitive (IS) based on the modified insulin suppression test. Computerized tomography was used to quantify visceral adipose tissue (VAT), sc adipose tissue (SAT), and thigh adipose tissue. Fat mass in each depot was compared according to IR/IS group, adjusting for BMI and sex. RESULTS: Despite nearly identical mean BMI in the IR vs. IS groups, VAT and %VAT were significantly higher in the IR group, whereas SAT, %SAT, and thigh sc fat were significantly lower. In logistic regression analysis, each sd increase in VAT increased the odds of being IR by 80%, whereas each increase in SAT decreased the odds by 48%; each increase in thigh fat decreased the odds by 59% and retained significance after adjusting for other depots. When grouped by VAT tertile, IS vs. IR individuals had significantly more SAT. There was no statistically significant interaction between sex and these relationships. CONCLUSION: These data demonstrate that after adjustment for BMI and VAT mass, sc abdominal and thigh fat are protective for insulin resistance, whereas VAT, after adjustment for SAT and BMI, has the opposite effect. Whether causal in nature or a marker of underlying pathology, these results clarify that regional distribution of fat-favoring sc depots is associated with lower risk for insulin resistance.
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Excess accumulation of SAT is much less likely to cause insulin resistance and metabolic dysfunction and explains why IR is not observed in all obese individuals.
“In addition, excess accumulation of SAT is much less likely to cause IR and metabolic dysfunction and explains why IR is not observed in all obese individuals [151,181].”
From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [181]
An increase in VAT is thought to reflect the relative inability of the subcutaneous adipose tissue depot to sufficiently expand its clearance and storage capacity in response to caloric excess.
“An increase in VAT is thought to reflect the relative inability of the subcutaneous adipose tissue depot to sufficiently expand its clearance and storage capacity in response to caloric excess (44).”
From The CardioMetabolic Health Alliance (2015) · cites this paper as [44]
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- Authors
- McLaughlin, T., Lamendola, C., Liu, A., & Abbasi, F.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- McLaughlin, Tracey
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-11-01
- Volume
- 96
- Issue
- 11
- Pages
- E1756-E1760
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3205890
- OpenAlex
- W2086823329
- Cited by
- 468
- References
- 21
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 38 · 2023: 38 · 2022: 32 · 2021: 36 · 2020: 30 · 2019: 38 · 2018: 36 · 2017: 34 · 2016: 28 · 2015: 29 · 2014: 39 · 2013: 23 · 2012: 20
- FWCI
- 22.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK071309, R01DK071333)
- National Center for Research Resources (K23RR016071, RR 000070, M01RR000070, 5K23 RR16071)
- 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
- insulin resistance, insulin sensitivity, visceral adipose tissue, subcutaneous adipose tissue, regional fat distribution, thigh fat, visceral-to-subcutaneous fat ratio, overweight adults, obesity
- MeSH terms
- Adult, Aged, Female, Humans, Insulin Resistance, Male, Middle Aged, Radiography, Sex Factors, Body Mass Index, Subcutaneous Fat, Intra-Abdominal Fat, Adiposity, Overweight
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