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01.10.2009 | Article

Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study

verfasst von: A. J. G. Hanley, L. E. Wagenknecht, J. M. Norris, M. Bryer-Ash, Y. I. Chen, A. M. Anderson, R. Bergman, S. M. Haffner

Erschienen in: Diabetologia | Ausgabe 10/2009

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Abstract

Aims/hypothesis

Central obesity, insulin resistance and beta cell dysfunction are independent risk factors for incident type 2 diabetes, although few studies have used detailed measures of these disorders. Our objective was to study the association of directly measured visceral and subcutaneous adipose tissue (VAT, SAT), insulin sensitivity (S _I) and the acute insulin response (AIR) with incident type 2 diabetes.

Methods

Participants were 1,230 Hispanic-Americans and African-Americans in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study who were free of type 2 diabetes at baseline (2000–2002). S _I and AIR were determined from frequently sampled IVGTTs with minimal model analysis. VAT and SAT were determined by computed tomography. Impaired fasting glucose and type 2 diabetes were defined according to American Diabetes Association criteria.

Results

Incident type 2 diabetes was diagnosed in 90 participants after 5 years. After adjustment for age, sex, ethnicity, centre, impaired fasting glucose, triacylglycerol, HDL-cholesterol and systolic BP, both S_I and AIR were inversely associated with type 2 diabetes (S _I, OR 0.53, 95% CI 0.39–0.73; AIR, OR 0.22, 95% CI 0.14–0.34 per SD; both p < 0.001), while both VAT and SAT were positively associated with type 2 diabetes (VAT, OR 1.68, 95% CI 1.22–2.33; SAT, OR 1.49, 95% CI 1.13–1.99; both p < 0.01). In a model including all four factors, S _I and AIR (S _I, OR 0.55, 95% CI 0.37–0.80; AIR, OR 0.21, 95% CI 0.13–0.33; both p < 0.01) were significant predictors of type 2 diabetes, although associations with VAT and SAT were no longer significant. A significant sex × VAT interaction indicated a stronger association of VAT with type 2 diabetes in women than in men.

Conclusions/interpretation

Insulin resistance, beta cell dysfunction and VAT predicted incident type 2 diabetes, with evidence of a stronger association of VAT with type 2 diabetes among women.

Carey VJ, Walters EE, Colditz GA et al (1997) Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses Health Study. Am J Epidemiol 145:614–619PubMed

Folsom AR, Kushi LH, Anderson KE et al (2000) Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women's Health Study. Arch Intern Med 160:2117–2128PubMedCrossRef

Ohlson LO, Larsson B, Svardsdudd K (1985) The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes 34:1055–1058PubMedCrossRef

Wang Y, Rimm EB, Stampfer MJ, Willet WC, Hu FB (2005) Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. Am J Clin Nutr 81:555–563PubMed

Despres JP, Lemieux I (2006) Abdominal obesity and metabolic syndrome. Nature 444:881–887PubMedCrossRef

Jensen MD (2006) Is visceral fat involved in the pathogenesis of the metabolic syndrome? Human model. Obesity (Silver Spring) 14(Suppl 1):20S–24SCrossRef

Bergman RN, Kim SP, Hsu IR et al (2007) Abdominal obesity: role in the pathophysiology of metabolic disease and cardiovascular risk. Am J Med 120(2 Suppl 1):S3–S8, discussion S29–S32PubMedCrossRef

Atzmon G, Yang XM, Muzumdar R, Ma XH, Gabriely I, Barzilai N (2002) Differential gene expression between visceral and subcutaneous fat depots. Horm Metab Res 34:622–628PubMedCrossRef

Iacobellis G (2005) Imaging of visceral adipose tissue: an emerging diagnostic tool and therapeutic target. Curr Drug Targets Cardiovasc Haematol Disord 5:345–353PubMedCrossRef

10.

Hanley AJG, Wagenknecht LE (2008) Abdominal adiposity and diabetes risk: the importance of precise measures and longitudinal studies (invited commentary). Diabetes 57:1153–1155PubMedCrossRef

11.

Wagenknecht L, Langefield C, Scherzinger A, Norris J et al (2003) Insulin sensitivity, insulin secretion, and abdominal fat: the Insulin resistance Atherosclerosis Study (IRAS) Family Study. Diabetes 52:2490–2496PubMedCrossRef

12.

Fox CS, Massaro JM, Hoffmann U et al (2007) Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 116:39–48PubMedCrossRef

13.

Pou KM, Massaro JM, Hoffman U et al (2007) Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study. Circulation 116:1234–1241PubMedCrossRef

14.

Boyko EJ, Fujimoto WY, Leonetti DL, Newell-Morris L (2000) Visceral adiposity and risk of type 2 diabetes. A prospective study among Japanese Americans. Diabetes Care 23:465–471PubMedCrossRef

15.

Kanaya AM, Wassel Fyr C, Vittinghoff E et al (2006) Adipocytokines and incident diabetes mellitus in older adults: the independent effect of plasminogen activator inhibitor 1. Arch Intern Med 166:350–356PubMedCrossRef

16.

Henkin L, Bergman RN, Bowden DW et al (2003) Genetic epidemiology of insulin resistance and visceral adiposity: the IRAS Family Study Design and Methods. Ann Epidemiol 13:211–217PubMedCrossRef

17.

Hanley AJG, Bowden D, Wagenknecht LE et al (2007) Associations of adiponectin with body fat distribution and insulin sensitivity in non-diabetic Hispanic and African Americans. J Clin Endocrinol Metab 92:2665–2671PubMedCrossRef

18.

Bergman RN, Finegood DT, Ader M (1985) Assessment of insulin sensitivity in vivo. Endocrine Rev 6:45–86CrossRef

19.

Welch S, Gebhart SSP, Bergman RN, Phillips LS (1990) Minimal model analysis of intravenous glucose tolerance test derived insulin sensitivity in diabetic subjects. J Clin Endocrinol Metab 71:1508–1518PubMedCrossRef

20.

Steil GM, Volund A, Kahn SE, Bergman RN (1993) Reduced sample number for calculation of insulin sensitivity and glucose effectiveness from the minimal model: suitability for use in population studies. Diabetes 42:250–256PubMedCrossRef

21.

Pacini G, Bergman RN (1986) MINMOD: a computer program to calculate insulin sensitivity and pancreatic responsivity from the frequently sampled intravenous glucose tolerance test. Comput Methods Programs Biomed 23:113–122PubMedCrossRef

22.

Bergman RN, Finegood DT, Kahn SE (2002) The evolution of beta cell dysfunction and insulin resistance in type 2 diabetes. Eur J Clin Invest 32(Suppl 3):35–45PubMedCrossRef

23.

Herbert V, Lau K, Gottlieb C, Bleicher S (1965) Coated charcoal immunoassay of insulin. J Clin Endocrinol Metab 25:1375–1384PubMedCrossRef

24.

Albu JB, Murphy L, Frager DH, Johnson JA, Pi-Sunyer F (1997) Visceral fat and race-dependent health risks in obese nondiabetic premenopausal women. Diabetes 46:456–462PubMedCrossRef

25.

Hill JO, Sidney S, Lewis CE, Tolan K, Scherzinger AL, Stamm ER (1999) Racial differences in amounts of visceral adipose tissue in young adults: the CARDIA (Coronary Artery Risk Development in Young Adults) Study. Am J Clin Nutr 69:381–387PubMed

26.

Macor C, Ruggeri A, Mazzonetto P, Federspil G, Cobelli C, Vettor R (1997) Visceral adipose tissue impairs insulin secretion and insulin sensitivity but not energy expenditure in obesity. Metabolism 46:123–129PubMedCrossRef

27.

Hayashi T, Boyko EJ, Leonetti DL et al (2003) Visceral adiposity and the risk of impaired glucose tolerance: a prospective study among Japanese Americans. Diabetes Care 26:650–655PubMedCrossRef

28.

Kanaya AM, Harris T, Goodpaster BH, Tylavsky F, Cummings SR, Health, Aging, and Body Composition (ABC) Study (2004) Adipocytokines attenuate the association between visceral adiposity and diabetes in older adults. Diabetes Care 27:1375–1380PubMedCrossRef

29.

Nicklas BJ, Penninx BW, Cesari M et al (2004) Association of visceral adipose tissue with incident myocardial infarction in older men and women: the Health, Aging and Body Composition Study. Am J Epidemiol 160:741–749PubMedCrossRef

30.

Weyer C, Bogardus C, Mott DM, Pratley RE (1999) The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 104:787–794PubMedCrossRef

31.

Lillioja S, Mott DM, Spraul M et al (1993) Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. Prospective studies of Pima Indians. N Engl J Med 329:1988–1992PubMedCrossRef

32.

Warram JH, Sigal RJ, Martin BC, Krolewski AS, Soeldner JS (1996) Natural history of impaired glucose tolerance: follow-up at Joslin Clinic. Diabetes Med 13(Suppl 6):S40–S45

33.

Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR (1992) Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet 340:925–929PubMedCrossRef

34.

Hanley AJG, D'Agostino R Jr, Wagenknecht LE et al (2002) Increased proinsulin levels and decreased acute insulin response independently predict the incidence of type 2 diabetes in the Insulin Resistance Atherosclerosis Study. Diabetes 51:1263–1270PubMedCrossRef

Titel: Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study
verfasst von: A. J. G. Hanley
L. E. Wagenknecht
J. M. Norris
M. Bryer-Ash
Y. I. Chen
A. M. Anderson
R. Bergman
S. M. Haffner
Publikationsdatum: 01.10.2009
Verlag: Springer-Verlag
Erschienen in: Diabetologia / Ausgabe 10/2009
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-009-1464-y

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