Abstract
Objectives:
To examine the specific distribution of liver fat content, visceral and subcutaneous adiposity in normal glucose tolerance (NGT/NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined conditions (IFG+IGT), as well as with newly diagnosed type 2 diabetes (nT2D).
Design:
Multicenter, international observational study: cross-sectional analysis.
Subjects:
Two thousand five hundred and fifteen patients (50.0% women, 54.5% non-Caucasian) without previously known diabetes were recruited from 29 countries. Abdominal fat distribution was measured by computed tomography (CT). Liver fat was estimated using the CT-liver mean attenuation.
Results:
Compared with NGT/NGT patients, increased visceral adiposity was found in iIFG, iIGT, IFG+IGT and nT2D; estimated liver fat progressively increased across these conditions. A one-s.d. increase in visceral adiposity was associated with an increased risk of having iIFG (men: odds ratio (OR) 1.41 (95% confidence interval (CI) 1.15–1.74), women: OR 1.62 (1.29–2.04)), iIGT (men: OR 1.59 (1.15–2.01), women: OR 1.30 (0.96–1.76)), IFG+IGT (men: OR 1.64 (1.27–2.13), women: OR 1.83 (1.36–2.48)) and nT2D (men: OR 1.80 (1.35–2.42), women: OR 1.73 (1.25–2.41)). A one-s.d. increase in estimated liver fat was associated with iIGT (men: OR 1.46 (1.12–1.90), women: OR 1.81 (1.41–2.35)), IFG+IGT (men: OR 1.42 (1.14–1.77), women: OR 1.74 (1.35–2.26)) and nT2D (men: OR 1.77 (1.40–2.27), women: OR 2.38 (1.81–3.18)). Subcutaneous abdominal adipose tissue showed an inverse relationship with nT2D in women (OR 0.63 (0.45–0.88)).
Conclusions:
Liver fat was associated with iIGT but not with iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D, whereas subcutaneous adiposity showed an inverse relationship with nT2D in women.
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Acknowledgements
Dr Borel is a postdoctoral fellow supported by a fellowship from Agiràdom (Meylan, France) and from the Rhône-Alpes region (France). Dr Nazare is a postdoctoral fellow supported by a fellowship from the CIHR (Canadian Institute of Health Research). The INSPIRE ME IAA was supported by SANOFI.
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Jean-Pierre Després has received a research grant from Eli Lilly, has received speaker’s fees from Abbott, AstraZeneca, Merck, GlaxoSmithKline and Pfizer Canada Inc. and is on the consultant/advisory board of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd, Abbott and Sanofi. All the other authors declare no conflict of interest.
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Borel, AL., Nazare, JA., Smith, J. et al. Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance. Int J Obes 39, 495–501 (2015). https://doi.org/10.1038/ijo.2014.163
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DOI: https://doi.org/10.1038/ijo.2014.163
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