Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, 72076 Tübingen, Germany.
German Center for Diabetes Research (DZD), 72076 Tübingen, Germany.
Nutrients. 2020 Jul 11;12(7):2064. doi: 10.3390/nu12072064.
Visceral adipose tissue (VAT) plays an important role in the pathogenesis of insulin resistance (IR), prediabetes and type 2 diabetes. However, VAT volume alone might not be the best marker for insulin resistance and prediabetes or diabetes, as a given VAT volume may impact differently on these metabolic traits based on body height, gender, age and ethnicity. In a cohort of 1295 subjects from the Tübingen Diabetes Family Study (TDFS) and in 9978 subjects from the UK Biobank (UKBB) undergoing magnetic resonance imaging for quantification of VAT volume, total adipose tissue (TAT) in the TDFS, total abdominal adipose tissue (TAAT) in the UKBB, and total lean tissue (TLT), VAT volume and several VAT-indices were investigated for their relationships with insulin resistance and glycemic traits. VAT-related indices were calculated by correcting for body height (VAT/m:VAT/body height; VAT/m:VAT/(body height), and VAT/m:VAT/(body height)), TAT (%VAT), TLT (VAT/TLT) and weight (VAT/WEI), with closest equivalents used within the UKBB dataset. Prognostic values of VAT and VAT-related indices for insulin sensitivity, HbA1c levels and prediabetes/diabetes were analyzed for males and females. Males had higher VAT volume and VAT-related indices than females in both cohorts ( < 0.0001) and VAT volume has shown to be a stronger determinant for insulin sensitivity than anthropometric variables. Among the parameters uncorrected VAT and derived indices, VAT/m most strongly correlated negatively with insulin sensitivity and positively with HbA1c levels and prediabetes/diabetes in the TDFS (R = 0.375/0.305 for females/males for insulin sensitivity, 0.178/0.148 for HbA1c levels vs., e.g., 0..355/0.293 and 0.144/0.133 for VAT, respectively) and positively with HbA1c (R = 0.046/0.042) in the UKBB for females and males. Furthermore, VAT/m was found to be a significantly better determinant of insulin resistance or prediabetes than uncorrected VAT volume ( < 0.001/0.019 for females/males regarding insulin sensitivity, < 0.001/< 0.001 for females/males regarding HbA1c).Evaluation of several indices derived from VAT volume identified VAT/m to correlate most strongly with insulin sensitivity and glucose metabolism. Thus, VAT/m appears to provide better indications of metabolic characteristics (insulin sensitivity and pre-diabetes/diabetes) than VAT volume alone.
内脏脂肪组织（VAT）在胰岛素抵抗（IR）、糖尿病前期和 2 型糖尿病的发病机制中起着重要作用。然而，仅 VAT 体积可能不是胰岛素抵抗和糖尿病前期或糖尿病的最佳标志物，因为给定的 VAT 体积可能会根据身高、性别、年龄和种族对这些代谢特征产生不同的影响。在一项来自图宾根糖尿病家族研究（TDFS）的 1295 名受试者队列和 UK Biobank（UKBB）的 9978 名受试者中，通过磁共振成像对 VAT 体积进行定量，在 TDFS 中研究了 VAT 相关指数与胰岛素抵抗和血糖特征的关系。在 UKBB 数据集中使用了最接近的等价物，对 VAT 体积和几个 VAT 指数进行了校正，以校正身体高度（VAT/m：VAT/身体高度；VAT/m：VAT/（身体高度），和 VAT/m：VAT/（身体高度））、总脂肪组织（%VAT）、总瘦组织（TLT）、VAT/TLT 和体重（VAT/WEI）。分析了男性和女性 VAT 和 VAT 相关指数对胰岛素敏感性、HbA1c 水平和糖尿病前期/糖尿病的预测价值。在两个队列中，男性的 VAT 体积和 VAT 相关指数均高于女性（<0.0001），并且 VAT 体积比人体测量变量更能决定胰岛素敏感性。在未校正的 VAT 和衍生指数中，VAT/m 与 TDFS 中胰岛素敏感性的相关性最强（女性为负 0.375/男性为负 0.305，与 HbA1c 水平的相关性最强为正 0.178/男性为正 0.148，而与 VAT 的相关性分别为正 0.355/男性为正 0.293 和正 0.144/男性为正 0.133），与 HbA1c 呈正相关（女性和男性分别为正 0.046/正 0.042）。此外，在 UKBB 中，VAT/m 被发现是胰岛素抵抗或糖尿病前期的一个更好的决定因素，与未校正的 VAT 体积相比（女性和男性关于胰岛素敏感性的<0.001/0.019，女性和男性关于 HbA1c 的<0.001/<0.001）。对来自 VAT 体积的几个指数的评估确定了 VAT/m 与胰岛素敏感性和葡萄糖代谢的相关性最强。因此，与单独的 VAT 体积相比，VAT/m 似乎能更好地反映代谢特征（胰岛素敏感性和糖尿病前期/糖尿病）。
