Subcutaneous abdominal fat and thigh muscle composition predict insulin sensitivity independently of visceral fat
Abstract
Whether visceral adipose tissue has a uniquely powerful association with insulin resistance or whether subcutaneous abdominal fat shares this link has generated controversy in the area of body composition and insulin sensitivity. An additional issue is the potential role of fat deposition within skeletal muscle and the relationship with insulin resistance. To address these matters, the current study was undertaken to measure body composition, aerobic fitness, and insulin sensitivity within a cohort of sedentary healthy men (n = 26) and women (n = 28). The subjects, who ranged from lean to obese (BMI 19.6-41.0 kg/m2), underwent dual energy X-ray absorptiometry (DEXA) to measure fat-free mass (FFM) and fat mass (FM), computed tomography to measure cross-sectional abdominal subcutaneous and visceral adipose tissue, and computed tomography (CT) of mid-thigh to measure muscle cross-sectional area, muscle attenuation, and subcutaneous fat. Insulin sensitivity was measured using the glucose clamp technique (40 mU · m∼2 · min−1), in conjunction with [3-3H]glucose isotope dilution. Maximal aerobic power (Vo2max) was determined using an incremental cycling test. Insulin-stimulated glucose disposal (Rd) ranged from 3.03 to 16.83 mg · min−1· kg−1 FFM. Rd was negatively correlated with FM (r = -0.58), visceral fat (r = -0.52), subcutaneous abdominal fat (r = -0.61), and thigh fat (r = -0.38) and positively correlated with muscle attenuation (r = 0.48) and Vo2max (r = 0.26, P < 0.05). In addition to manifesting the strongest simple correlation with insulin sensitivity, in stepwise multiple regression, subcutaneous abdominal fat retained significance after adjusting for visceral fat, while the converse was not found. Muscle attenuation contributed independent significance to multiple regression models of body composition and insulin sensitivity, and in analysis of obese subjects, muscle attenuation was the strongest single correlate of insulin resistance. In summary, as a component of central adiposity, subcutaneous abdominal fat has as strong an association with insulin resistance as visceral fat, and altered muscle composition, suggestive of increased fat content, is an important independent marker of insulin resistance in obesity.
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Lipid infiltration is an important determinant of insulin resistance in healthy and diseased patients; it is independent of visceral fat and is associated with decreased muscle strength and physical performance in older persons.
“As determined by the computerized tomography (CT) attenuation coefficient of muscle, lipid infiltration is an important determinant of insulin resistance in healthy (45) and diseased patients (46): it is independent of visceral fat and is associated with decreased muscle strength and physical performance in older persons (47).”
From Discovering pathways of sarcopenia in older adults: a role for insulin resistance on mitochondria dysfunction (2011) · cites this paper as [45]
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- Authors
- Goodpaster, B. H., Leland Thaete, F., Simoneau, J.-A., & Kelley, D. E.
- Affiliations
- University of Pittsburgh (US)
- Departments of Medicine and Radiology, University of Pittsburgh Pittsburgh, Pennsylvania
- Université Laval (CA)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 1997-10-01
- Volume
- 46
- Issue
- 10
- Pages
- 1579-1585
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2085194341
- Cited by
- 1,012
- References
- 0
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 21 · 2023: 18 · 2022: 32 · 2021: 35 · 2020: 41 · 2019: 22 · 2018: 30 · 2017: 32 · 2016: 31 · 2015: 44 · 2014: 48 · 2013: 49 · 2012: 34
- FWCI
- 11.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30dk046204-15)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK49200-02, 1P30DK-46204, R01DK049200)
- National Center for Research Resources (M01RR000056)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- insulin sensitivity, insulin resistance, subcutaneous abdominal fat, visceral adipose tissue, muscle attenuation, body composition, cardiorespiratory fitness, obesity, abdominal obesity, glucose disposal
- MeSH terms
- Abdomen, Adipose Tissue, Adult, Blood Glucose, Body Composition, Female, Humans, Indicator Dilution Techniques, Insulin, Insulin Resistance, Male, Middle Aged, Thigh, Tomography, X-Ray Computed, Tritium, Viscera, Glucose Clamp Technique, Absorptiometry, Photon, Body Mass Index, Muscle, Skeletal
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