Ingram K H, Hunter G R, James J F, Gower B A
Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA.
Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, USA.
Int J Obes (Lond). 2017 Aug;41(8):1214-1217. doi: 10.1038/ijo.2017.104. Epub 2017 May 3.
BACKGROUND/OBJECTIVES: Childbearing is associated with a disproportionate accumulation of visceral fat and an increased risk of metabolic disease. However, it is unknown whether the visceral fat accretion associated with pregnancy modifies a woman's risk for metabolic disease. The purpose of this study was to test whether the association between abdominal fat and insulin sensitivity differs by parity status in healthy overweight women.
SUBJECTS/METHODS: Intra-abdominal adipose tissue (IAAT) via CT, body composition by DXA, insulin sensitivity via intravenous glucose tolerance test and minimal model (S), HOMA-IR, and cardiorespiratory fitness (VO) were assessed in 212 non-diabetic, premenopausal, overweight non-Hispanic white and African-American women.
Nulliparous women (n=98) were younger, had less IAAT and higher VO, but similar S HOMA-IR and leg fat, compared to parous (n=114). In nulliparous women, IAAT was negatively associated with S, controlling for age, race and body fat mass (r=-0.40, P<0.001), but this relationship was attenuated in parous women (r=-0.15, P=0.16). In multiple linear regression analysis, leg fat and IAAT were significant predictors of S in nulliparous, but not parous women.
Results suggest that greater IAAT in parous women does not lead to greater insulin resistance; rather, transient insulin resistance during pregnancy may encourage intra-abdominal fat accumulation that is metabolically benign. This underscores the need to consider parity when assessing cardiometabolic risk.
背景/目的：生育与内脏脂肪不成比例的积累以及代谢疾病风险增加有关。然而，与妊娠相关的内脏脂肪增加是否会改变女性患代谢疾病的风险尚不清楚。本研究的目的是测试在健康超重女性中，腹部脂肪与胰岛素敏感性之间的关联是否因生育状况而异。
受试者/方法：对212名非糖尿病、绝经前、超重的非西班牙裔白人和非裔美国女性进行了如下评估：通过CT测量腹内脂肪组织（IAAT），通过双能X线吸收法（DXA）测量身体成分，通过静脉葡萄糖耐量试验和最小模型评估胰岛素敏感性（S）、稳态模型评估胰岛素抵抗（HOMA-IR）以及心肺适能（VO）。
与经产妇（n=114）相比，未生育女性（n=98）更年轻，IAAT更少，VO更高，但S、HOMA-IR和腿部脂肪相似。在未生育女性中，控制年龄、种族和体脂量后，IAAT与S呈负相关（r=-0.40，P<0.001），但在经产妇中这种关系减弱（r=-0.15，P=0.16）。在多元线性回归分析中，腿部脂肪和IAAT是未生育女性而非经产妇中S的显著预测因素。
结果表明，经产妇中较高的IAAT不会导致更大的胰岛素抵抗；相反，孕期短暂的胰岛素抵抗可能会促进代谢上良性的腹内脂肪堆积。这凸显了在评估心血管代谢风险时考虑生育状况的必要性。
