Department of Medicine, University of Washington, Seattle, WA, USA.
Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Diabetes Res Clin Pract. 2019 Aug;154:17-26. doi: 10.1016/j.diabres.2019.06.008. Epub 2019 Jun 19.
We examined the longitudinal association between change in body composition directly measured by computed tomography (CT) and future insulin sensitivity.
This was a prospective study with 10 years of follow-up with 297 Japanese-American without diabetes. Intra-abdominal fat area (IAFA) and abdominal subcutaneous fat area (SCFA), and thigh SCFA were measured by CT. Insulin sensitivity was calculated by HOMA-IR and the Matsuda index.
Baseline and change in IAFA were significantly and independently associated with change in HOMA-IR and Matsuda index during follow-up. In multivariate analysis, IAFA and 10-year change in IAFA (Δ IAFA) was significantly and positively associated with 10-year HOMA-IR (p < 0.001) and significantly and negatively associated with 10-year Matsuda index (p < 0.001). The association with Matsuda index though was non-linear and best modeled as a quadratic function (Δ IAFA + Δ IAFA). No significant associations in multivariate analyses were seen between thigh SCFA and insulin sensitivity or abdominal SCFA and HOMA-IR but an increase in abdominal SCFA was associated with diminished insulin sensitivity measured by the Matsuda index.
An increase in visceral adiposity predicts diminished insulin sensitivity over 10 years of follow-up independent of the size of this adipose depot at baseline.
我们通过计算机断层扫描（CT）直接测量的身体成分变化与未来胰岛素敏感性之间的纵向关联进行了研究。
这是一项前瞻性研究，随访时间为 10 年，共有 297 名没有糖尿病的日裔美国人参与。通过 CT 测量腹内脂肪面积（IAFA）和腹部皮下脂肪面积（SCFA）以及大腿 SCFA。胰岛素敏感性通过 HOMA-IR 和 Matsuda 指数计算。
基线和 IAFA 的变化与随访期间 HOMA-IR 和 Matsuda 指数的变化显著相关。在多变量分析中，IAFA 和 IAFA 的 10 年变化（ΔIAFA）与 10 年 HOMA-IR 显著正相关（p<0.001），与 10 年 Matsuda 指数显著负相关（p<0.001）。尽管与 Matsuda 指数的关联是非线性的，但最佳模型为二次函数（ΔIAFA+ΔIAFA）。大腿 SCFA 与胰岛素敏感性之间或腹部 SCFA 与 HOMA-IR 之间在多变量分析中没有显著关联，但腹部 SCFA 的增加与 Matsuda 指数衡量的胰岛素敏感性降低有关。
内脏脂肪增加可预测在 10 年随访期间胰岛素敏感性降低，而与基线时该脂肪储存量的大小无关。
