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Insulin Resistance And Plasma Leptin Association Explained By Distinct Areas Of Body Fat Accumulation
A DGReview of :"The Concurrent Accumulation of Intra-Abdominal and Subcutaneous Fat Explains the Association Between Insulin Resistance and Plasma Leptin Concentrations: Distinct Metabolic Effects of Two Fat Compartments"
Diabetes
04/04/2002
By James Adams
Accumulation of intra-abdominal fat is associated with insulin resistance, whereas accumulation of subcutaneous fat is associated with increased plasma leptin levels.
Concurrent accumulation of fat in these two metabolically distinct fat compartments explains the association between insulin resistance and increased levels of plasma leptin observed in both lean and obese subjects.
Investigators from multiple institutions, including the Veterans Administration Puget Sound Health Care System, Harborview Medical Center and the University of Washington in Seattle, Washington, United States, evaluated body fat distribution, and its contribution to insulin sensitivity and leptin levels in both lean an obese subjects.
Of 174 study subjects, 73 men and 101 women, 56 were classified as lean insulin-sensitive, 61 were lean insulin-resistant and 57 were obese insulin-resistant, according to body mass index and insulin sensitivity index. Body mass index was similar between the two lean groups.
Subcutaneous fat was 45 percent higher in lean insulin-resistant and 250 percent higher in obese insulin-resistant subjects compared to those who were lean insulin-sensitive. Intra-abdominal fat was 75 percent higher in lean insulin-resistant and 300 percent higher in obese insulin-resistant subjects compared to those who were lean insulin-sensitive.
Fasting levels of plasma leptin were moderately elevated in the lean insulin-resistant subjects and doubled in the obese insulin-resistant subjects compared the insulin-sensitive subjects.
Intra-abdominal fat was the best predictor of insulin sensitivity in both males and females. It explained 54 percent of the variance in insulin resistance index. Fasting leptin levels, however, were associated with subcutaneous fat and not intra-abdominal fat.
Diabetes 2002; 51: 1005-1015.
"The Concurrent Accumulation of Intra-Abdominal and Subcutaneous Fat Explains the Association Between Insulin Resistance and Plasma Leptin Concentrations: Distinct Metabolic Effects of Two Fat Compartments"
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