Goodpaster Bret H, Krishnaswami Shanthi, Resnick Helaine, Kelley David E, Haggerty Catherine, Harris Tamara B, Schwartz Ann V, Kritchevsky Steven, Newman Anne B
Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Diabetes Care. 2003 Feb;26(2):372-9. doi: 10.2337/diacare.26.2.372.
We examined whether regional adipose tissue distribution, specifically that of skeletal muscle fat and visceral abdominal fat aggregation, is characteristic of elderly individuals with hyperinsulinemia, type 2 diabetes, and impaired glucose tolerance (IGT).
A total of 2,964 elderly men and women (mean age 73.6 years) were recruited for cross-sectional comparisons of diabetes or glucose tolerance, generalized obesity with dual-energy X-ray absorptiometry, and regional body fat distribution with computed tomography. RESULTS-Approximately one-third of men with type 2 diabetes and less than half of women with type 2 diabetes were obese (BMI > or =30 kg/m(2)). Despite similar amounts of subcutaneous thigh fat, intermuscular fat was higher in subjects with type 2 diabetes and IGT than in subjects with normal glucose tolerance (NGT) (11.2 +/- 9.4, 10.3 +/- 5.8, and 9.2 +/- 5.9 cm(2) for men; 12.1 +/- 6.1, 10.9 +/- 6.5, and 9.4 +/- 5.3 cm(2) for women; both P < 0.0001). Visceral abdominal fat was also higher in men and women with type 2 diabetes and IGT than in subjects with NGT (172 +/- 79, 163 +/- 72, and 145 +/- 66 cm(2) for men; 162 +/- 66, 141 +/- 60, and 116 +/- 54 cm(2) for women; both P < 0.0001 across groups). Higher rates of intermuscular fat and visceral abdominal fat were associated with higher fasting insulin in normal-weight (BMI <25 kg/m(2)) men (r = 0.24 for intermuscular fat, r = 0.37 for visceral abdominal fat, both P < 0.0001) and women (r = 0.20 for intermuscular fat, r = 0.40 for visceral abdominal fat, both P < 0.0001). These associations were not found in obese subjects.
Elderly men and women with normal body weight may be at risk for metabolic abnormalities, including type 2 diabetes, if they possess an inordinate amount of muscle fat or visceral abdominal fat.
我们研究了局部脂肪组织分布，特别是骨骼肌脂肪和内脏腹部脂肪聚集情况，是否为患有高胰岛素血症、2型糖尿病和糖耐量受损（IGT）的老年人的特征。
共招募了2964名老年男性和女性（平均年龄73.6岁），用于对糖尿病或糖耐量、通过双能X线吸收法测量的全身性肥胖以及通过计算机断层扫描测量的局部身体脂肪分布进行横断面比较。结果——约三分之一的2型糖尿病男性和不到一半的2型糖尿病女性肥胖（体重指数≥30kg/m²）。尽管大腿皮下脂肪量相似，但2型糖尿病和IGT患者的肌间脂肪高于糖耐量正常（NGT）患者（男性分别为11.2±9.4、10.3±5.8和9.2±5.9cm²；女性分别为12.1±6.1、10.9±6.5和9.4±5.3cm²；P均<0.0001）。2型糖尿病和IGT的男性和女性的内脏腹部脂肪也高于NGT患者（男性分别为172±79、163±72和145±66cm²；女性分别为162±66、141±60和116±54cm²；各组间P均<0.0001）。在体重正常（体重指数<25kg/m²）的男性（肌间脂肪r=0.24，内脏腹部脂肪r=0.37，P均<0.0001）和女性（肌间脂肪r=0.20，内脏腹部脂肪r=0.40，P均<0.0001）中，较高的肌间脂肪和内脏腹部脂肪率与较高的空腹胰岛素水平相关。在肥胖受试者中未发现这些关联。
体重正常的老年男性和女性如果拥有过多的肌肉脂肪或内脏腹部脂肪，可能有发生包括2型糖尿病在内的代谢异常的风险。
