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Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO grade III obesity
Author(s) -
Yang L.,
Samarasinghe Y. P.,
Kane P.,
Amiel S. A.,
Aylwin S. J. B.
Publication year - 2010
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2009.03772.x
Subject(s) - insulin resistance , waist , medicine , endocrinology , body mass index , obesity , adipose tissue , insulin , abdominal obesity , intra abdominal fat , visceral fat
Summary Objective Although associations between visceral adiposity (intra‐abdominal fat mass) and insulin resistance are well established, previous data include few subjects with WHO grade III obesity [body mass index (BMI) > 40 kg/m 2 ]. We have investigated the relationship between visceral adiposity and insulin resistance using computed tomography (CT)‐quantified fat mass and the homeostasis model assessment for insulin resistance (HOMA‐IR) in patients with severe obesity. Patients and methods Eighteen nondiabetic subjects with BMI > 40 kg/m 2 were recruited. BMI, and waist, hip and neck circumferences were measured. Fasting plasma insulin and glucose were measured to calculate HOMA‐IR. A single slice CT scan was taken at L4 and visceral and abdominal subcutaneous adipose tissue (VAT and ASAT, respectively) quantified using ‘SliceOmatic’ image analysis software. Results A close correlation was demonstrated between VAT and HOMA‐IR ( r 2 = 0·46, P = 0·002), whereas ASAT showed no relationship. Neck circumference correlated with both VAT ( r 2 = 0·67, P < 0·0001) and HOMA‐IR ( r 2 = 0·35, P = 0·01). Waist circumference only correlated significantly with VAT ( r 2 = 0·25, P = 0·03). Conclusions Visceral adiposity remains a strongly significant indicator of insulin resistance in WHO grade III obesity. Neck circumference surpasses other anthropometric measurements as a powerful marker of both VAT and insulin resistance.