The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat.
Open accessAbstract
Obesity and insulin resistance are both associated with an atherogenic lipoprotein profile. We examined the effect of insulin sensitivity and central adiposity on lipoproteins in 196 individuals (75 men and 121 women) with an average age of 52.7 years. Subjects were subdivided into three groups based on BMI and their insulin sensitivity index (S(I)): lean insulin sensitive (n = 65), lean insulin resistant (n = 73), and obese insulin resistant (n = 58). This categorization revealed that both obesity and insulin resistance determined the lipoprotein profile. In addition, the insulin-resistant groups had increased central adiposity. Increasing intra-abdominal fat (IAF) area, quantified by computed tomography scan and decreasing S(I), were important determinants of an atherogenic profile, marked by increased triglycerides, LDL cholesterol, and apolipoprotein B and decreased HDL cholesterol and LDL buoyancy (Rf). Density gradient ultracentrifugation (DGUC) revealed that in subjects who had more IAF and were more insulin resistant, the cholesterol content was increased in VLDL, intermediate-density lipoprotein (IDL), and dense LDL fractions whereas it was reduced in HDL fractions. Multiple linear regression analysis of the relation between the cholesterol content of each DGUC fraction as the dependent variable and IAF and S(I) as independent variables revealed that the cholesterol concentration in the fractions corresponding to VLDL, IDL, dense LDL, and HDL was associated with IAF, and that S(I) additionally contributed independently to VLDL, but not to IDL, LDL, or HDL. Thus an atherogenic lipoprotein profile appears to be the result primarily of an increase in IAF, perhaps via insulin resistance.
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In normal, randomly selected healthy populations, isolated visceral obesity and insulin resistance were associated with only a slight increase in triglyceride levels and only a slight decrease in HDL cholesterol levels.
“Importantly, in normal, randomly selected healthy populations, isolated visceral obesity and insulin resistance were associated with only a slight increase in triglyceride levels and only a slight decrease in HDL cholesterol levels (127).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [127]
The Lipoprotein measurements section (Table 2; page not indicated in our copy) reports higher triglycerides and lower HDL cholesterol in lean insulin-resistant subjects than in lean insulin-sensitive subjects. But the Subjects section says participants were recruited by advertisement, not randomly selected, and the paper notes that its groups did not isolate insulin resistance from abdominal fat. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIncreased visceral fat is associated with insulin resistance, hyperinsulinemia, low plasma adiponectin levels, and elevations in plasma NEFA levels.
“Increased visceral fat is associated with insulin resistance, hyperinsulinemia, low plasma adiponectin levels, and elevations in plasma NEFA levels ( 127).”
From Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline (2012) · cites this paper as [127]
The paper’s BMI, insulin sensitivity, and demographic measures section reports that intra-abdominal fat is strongly associated with lower insulin sensitivity; Table 1 also shows higher insulin levels in groups with more intra-abdominal fat. The copy does not report an association with low plasma adiponectin or elevated plasma NEFA levels. Page numbers were not provided for these indexed passages. (LLM, conf=0.88)
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References 75 · Cited by 281
- Authors
- Nieves, D. J., Cnop, M., Retzlaff, B., Walden, C. E., Brunzell, J. D., Knopp, R. H., & Kahn, S. E.
- Affiliations
- University of Washington (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2003-01-01
- Volume
- 52
- Issue
- 1
- Pages
- 172-179
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2138349577
- Cited by
- 281
- References
- 75
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 3 · 2022: 9 · 2021: 9 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 12 · 2014: 16 · 2013: 21 · 2012: 21
- FWCI
- 12.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Belgian American Educational Foundation
- University of Washington (DK17047, DK-35816)
- National Institutes of Health
- National Heart, Lung, and Blood Institute (P01HL030086, HL3-0086)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-35816, DK 02456, K24DK002654, DK 02654, DK-17047, P30DK035816, P30DK017047)
- National Center for Research Resources (RR 37)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- atherogenic lipoprotein profile, intra-abdominal fat, abdominal obesity, obesity, insulin resistance, insulin sensitivity index, lipoprotein cholesterol, VLDL, intermediate density lipoprotein, HDL cholesterol, triglycerides, apolipoprotein B, density gradient ultracentrifugation
- MeSH terms
- Abdomen, Adipose Tissue, Arteriosclerosis, Body Constitution, Female, Humans, Insulin Resistance, Lipoproteins, Male, Middle Aged, Obesity
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