Visceral obesity and diabetes.

The cross-sectional subcutaneous and visceral areas of adipose tissue, measured on computed tomographic scans at abdominal level and the subcutaneous/visceral fat area ratio (S/V ratio) distribution have been calculated in 155 subjects. Using the S/V ratio as discriminator, two groups of patients of both sexes, with subcutaneous or visceral type of obesity have been selected. Metabolic studies demonstrate a significant reduction of glucose tolerance at the oral glucose load and a significant increase of the insulin response in patients with visceral obesity. The size of the omental fat cells was larger in visceral obesity, while the size of subcutaneous fat cells was larger in subcutaneous obesity. A significant correlation was found between the S/V area ratios and the subcutaneous/visceral fat cell weight ratios. In vitro studies on subcutaneous and omental fat obtained during surgery from 9 patients with subcutaneous obesity and 7 patients with visceral obesity demonstrate a significantly higher isoprenaline-stimulated lipolytic response in omental fat of patients with visceral obesity. The lipoprotein lipase activity in subcutaneous fat was higher than in omental fat in both types of obesity.