Bajzová M, Kováciková M, Vítková M, Polák J, Klimcáková E, Srp A, Vedral T, Mikulásek L, Srámková S P, Stich V, Hejnová J
Oddelení telovýchovneho lékarství 3. LF UK, Praha.
Cas Lek Cesk. 2008;147(7):376-80.
Association of obesity with metabolic and cardiovascular complications depends on the adipose tissue distribution. The role of intraabdominal, i.e. visceral, adipose tissue in pathogenesis of insulin resistance is still not elucidated. The aim of this study was to investigate the relation between insulin resistance and contribution of visceral and subcutaneous fat in a group of women with a wide range of body weight.
62 women (age 21-66 years) among which 32 were non-obese and 30 obese (BMI > 30 kg/m2) were examined. The amount of visceral and subcutaneous fat was evaluated using computerized tomography, total body fat evaluated using bioimpedance, and the degree of insulin resistance was evaluated using glucose disposal (M) during euglycemic hyperinsulinemic clamp. Obese women had lower insulin sensitivity than non-obese (5.88 +/- 2.17 vs 3.32 +/- 1.44 mg/min/kg, p <0.001) and higher absolute amount of visceral fat. However, the relative amount of visceral fat (related to total body fat or subcutaneous fat) was not different between the two groups. In the entire study group, the magnitude of insulin sensitivity did correlate with absolute amount of total and visceral fat, but no correlation with relative amount of visceral fat was found.
The results suggest that the absolute amount of fat, either total or visceral, is a stronger predictor of the degree of insulin resistance than the relative contribution of visceral fat.
肥胖与代谢及心血管并发症的关联取决于脂肪组织的分布。腹内即内脏脂肪组织在胰岛素抵抗发病机制中的作用仍未阐明。本研究的目的是调查一组体重范围广泛的女性中胰岛素抵抗与内脏及皮下脂肪贡献之间的关系。
对62名女性（年龄21 - 66岁）进行了检查，其中32名非肥胖，30名肥胖（BMI>30kg/m²）。使用计算机断层扫描评估内脏和皮下脂肪量，使用生物电阻抗评估全身脂肪，在正常血糖高胰岛素钳夹期间使用葡萄糖处置（M）评估胰岛素抵抗程度。肥胖女性的胰岛素敏感性低于非肥胖女性（5.88±2.17对3.32±1.44mg/min/kg，p<0.001），且内脏脂肪的绝对量更高。然而，两组之间内脏脂肪的相对量（与全身脂肪或皮下脂肪相关）并无差异。在整个研究组中，胰岛素敏感性的程度确实与全身和内脏脂肪的绝对量相关，但未发现与内脏脂肪的相对量相关。
结果表明，无论是全身脂肪还是内脏脂肪的绝对量，比内脏脂肪的相对贡献更能预测胰岛素抵抗的程度。
