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Author Notes:

Correspondence: Nana Gletsu-Miller, Department of Nutrition Sciences, Purdue University, 700 W. State Street, Stone Hall, Room 202, West Lafayette, IN 47907, USA; Email: ngletsum@purdue.edu

Acknowledgments: We thank all the study participants.

Adeola T. Ayeni, MD, Emory University Department of Medicine, assisted with clinical research coordination of the study participants.

Disclosures: No conflict of interest.

The findings and conclusions in this article are those of the authors and do not necessarily reflect the official position of the Centers for Disease Control and Prevention.

Subjects:

Research Funding:

This work was supported by National Institute of Health grants R03 DK067167 and R21 DK 075745 (to NGM), K24 RR023356 (to TRZ), DK066204 (to LSP), General Clinical Research Center Grant M01 RR00039 and the Atlanta Clinical and Translational Science Institute grant UL1 RR025008 and the Veterans’ Association HSR&D awards SHP 08–144 and IIR 07–138 (to LSP).

Keywords:

  • Obesity
  • Type 2 diabetes
  • Waist circumference
  • Anthropometry
  • Intra-abdominal fat
  • Insulin resistance
  • Sagittal abdominal diameter

Sagittal abdominal diameter and visceral adiposity: correlates of beta-cell function and dysglycemia in severely obese women

Tools:

Journal Title:

Obesity Surgery

Volume:

Volume 23, Number 7

Publisher:

, Pages 874-881

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background In the context of increasing obesity prevalence, the relationship between large visceral adipose tissue (VAT) volumes and type 2 diabetes mellitus (T2DM) is unclear. In a clinical sample of severely obese women (mean body mass index [BMI], 46 kg/m2) with fasting normoglycemia (n=40) or dysglycemia (impaired fasting glucose+diabetes; n=20), we sought to determine the usefulness of anthropometric correlates of VAT and associations with dysglycemia. Methods VAT volume was estimated using multi-slice computer tomography; anthropometric surrogates included sagittal abdominal diameter (SAD), waist circumference (WC) and BMI. Insulin sensitivity (Si), and beta-cell dysfunction, measured by insulin secretion (AIRg) and the disposition index (DI), were determined by frequently sampled intravenous glucose tolerance test. Results Compared to fasting normoglycemic women, individuals with dysglycemia had greater VAT (P<0.001) and SAD (P=0.04), but BMI, total adiposity and Si were similar. VAT was inversely associated with AIRg and DI after controlling for ancestry, Si, and total adiposity (standardized beta, −0.32 and −0.34, both P<0.05). In addition, SAD (beta=0.41, P=0.02) was found to be a better estimate of VAT volume than WC (beta=0.32, P=0.08) after controlling for covariates. Receiver operating characteristic analysis showed that VAT volume, followed by SAD, outperformed WC and BMI in identifying dysglycemic participants. Conclusions Increasing VAT is associated with beta-cell dysfunction and dysglycemia in very obese women. In the presence of severe obesity, SAD is a simple surrogate of VAT, and an indicator of glucose dysregulation.

Copyright information:

© Springer Science+Business Media New York 2013

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