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Femoral–gluteal adiposity is not associated with insulin sensitivity in Type 1 diabetes
Author(s) -
Shay C. M.,
Secrest A. M.,
Miller R. G.,
Strotmeyer E. S.,
Goodpaster B. H.,
Kelsey S. F.,
Orchard T. J.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2012.03728.x
Subject(s) - medicine , endocrinology , diabetes mellitus , insulin , type 2 diabetes , body mass index , trunk , insulin resistance , biology , ecology
Abstract Aims To quantify and compare associations between femoral–gluteal adiposity and insulin sensitivity in adults with Type 1 diabetes mellitus with adults with normal glucose tolerance. Methods Individuals with Type 1 diabetes ( n = 28) were recruited from the Pittsburgh Epidemiology of Diabetes Complication study, a 24‐year prospective study of childhood‐onset diabetes, and compared cross‐sectionally with individuals with normal glucose tolerance ( n = 56) of similar age, sex and BMI. Insulin sensitivity was defined as whole‐body glucose disposal measured by hyperinsulinaemic–euglycaemic clamps. Adiposity was quantified by dual energy X‐ray absorptiometry. Results Individuals with Type 1 diabetes exhibited lower insulin sensitivity (5.8 vs. 8.2 mg min −1 kg fat‐free mass −1 , P < 0.01), lower total fat mass (20.1 vs. 29.0 kg, P < 0.001) and lower proportional leg fat mass (36.0 vs.37.7%, P = 0.03), but similar proportional trunk fat (% trunk fat mass) compared with individuals with normal glucose tolerance. Overall, results from linear regression demonstrated that higher % leg fat mass ( P < 0.01) and lower % trunk fat mass ( P < 0.01) were independently associated with lower insulin sensitivity after adjustments for age, sex, height, total fat mass (kg) and diabetes status. Higher % leg fat mass was independently associated with higher insulin sensitivity in individuals with normal glucose tolerance ( P < 0.01) after similar adjustment; significant associations were not observed in Type 1 diabetes. Conclusions Reduced insulin sensitivity is a prominent feature of Type 1 diabetes and is associated with total and abdominal adiposity. Compared with adults with normal glucose tolerance, leg fat mass does not show any positive association with insulin sensitivity in Type 1 diabetes.