Visceral fat and blood sugar levels -
Obesity 19, — Gustafson, B. Regulation of white adipogenesis and its relation to ectopic fat accumulation and cardiovascular risk. Atherosclerosis , 27—35 Peterson, M.
Android adiposity and lack of moderate and vigorous physical activity are associated with insulin resistance and diabetes in aging adults. Lu, Y. New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk. Article CAS ADS Google Scholar.
Hastie, T. Exploring the nature of covariate effects in the propotional hazards model. Biometrics 46, — Wood, S. Generalized additive models: An introduction with R. R package version 1. Pussinen, P. Endotoxemia is associated with an increased risk of incident diabetes.
Burgner, D. Infection-related hospitalization in childhood and adult metabolic outcomes. Pediatrics , e— Peyrin-Biroulet, L. Gut 61, 78—85 Caesar, R. Crosstalk between gut microbiota and dietary lipids aggravates WAT inflammation through TLR signaling.
Cell Metab. Troseid, M. Plasma lipopolysaccharide is closely associated with glycemic control and abdominal obesity: evidence from bariatric surgery. Diabetes Care 36, — Endotoxin rapidly induces changes in lipid metabolism that produce hypertriglyceridemia: low doses stimulate hepatic triglyceride production while high doses inhibit clearance.
CAS PubMed Google Scholar. Hudgins, L. A single intravenous dose of endotoxin rapidly alters serum lipoproteins and lipid transfer proteins in normal volunteers. Download references. This study was supported by grants from the Signe and Ane Gyllenberg Foundation, Folkhälsan Research Foundation, the Wilhelm and Else Stockmann Foundation, the Liv och Hälsa Foundation, the Helsinki University Central Hospital Research Funds EVO , the Finnish Cultural Foundation, the Diabetes Research Foundation, the Novo Nordisk Foundation NNF14SA , Academy of Finland, Tekes and the Finnish Medical Society Finska Läkaresällskapet.
The skilled technical assistance of Anna Sandelin, and Jaana Tuomikangas is gratefully acknowledged. The authors also acknowledge all the physicians and nurses at each centre participating in the collection of patients online appendix. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Mariann I. Lassenius, Aila J. Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
National Institute for Health and Welfare, Helsinki, Finland. You can also search for this author in PubMed Google Scholar.
and A. contributed equally to the work. and M. designed the study and interpreted the results. analyzed the data. drafted the manuscript. gave valuable comments to the manuscript. All authors read and approved the final manuscript. This work is licensed under a Creative Commons Attribution 4.
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Skip to main content Thank you for visiting nature. nature scientific reports articles article. Download PDF. Subjects Risk factors Type 1 diabetes.
Abstract Bacterial lipopolysaccharides LPS , potent inducers of inflammation, have been associated with chronic metabolic disturbances. Introduction Bacterial endotoxins or lipopolysaccharides LPS are potent inducers of systemic inflammation.
Subjects and Methods Data from individuals with type 1 diabetes were collected during the Finnish Diabetic Nephropathy FinnDiane Study visits taking place in Helsinki between years and Statistical analyses Normality of variable distribution was assessed with the Kolmogorov-Smirnov test.
Ethics The study protocol was approved by the Ethics Committee of the Hospital District of Helsinki and Uusimaa. Results Patient characteristics divided by renal status are shown in Table 1. Table 1 Clinical characteristics of study participants divided by renal status.
Full size table. Figure 1. Full size image. Table 2 Factors associated with visceral fat mass. Discussion Inflammation and insulin resistance are intertwined processes that are strongly linked to overweight and intra-abdominal obesity. Fasting blood glucose is the current protocol for assessing metabolic impairment.
However, recent studies have shown young adults may have normal fasting blood glucose levels with underlying irregularities in postprandial glucose regulation, insulin secretion and cortisol release, which causes a pattern of visceral fat accumulation.
Visceral fat of the volunteers was assessed using the DXA Dual-energy X-ray absorptiometry full body scanning method; the waist was assessed by taking the circumference at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest to formulate a waist to height ratio WHtR ; fasting glucose levels were measured via point-of-care POC finger-stick method using the Abbott Precision blood glucose meter and anxiety levels.
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Thank you for anr Visceral fat and blood sugar levels. You are using a browser version with bloodd support vat CSS. Skincare for men obtain amd best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Bacterial lipopolysaccharides LPSpotent inducers of inflammation, have been associated with chronic metabolic disturbances. Obesity is linked to dyslipidemia, increased body adiposity, and endotoxemia.Amalia Gastaldelli, Yoshinori Miyazaki, Maura Leevels, Masafumi Suga, Srihanth Mahankali, Eleonora Viseral, Ralph Suga. Visceral fat VF excess has been associated with decreased peripheral insulin sensitivity and has been suggested to contribute to hepatic insulin resistance. Nutritional requirements for muscle reconstruction, the mechanisms by which VF impacts on hepatic glucose metabolism and the quantitative role of VF in glycemic control Skincare for men not been investigated.
In the present study 63 type 2 diabetic subjects age, boood ± 1 yr; fasting plasma glucose, 5. In contrast, the relation of basal endogenous glucose output to VF was not statistically sgar. We Skincare for men Whole Foods for Recovery in patients with Viscreal type 2 diabetes, VF accumulation has a far negative impact anr glycemic control through a decrease ,evels peripheral insulin sensitivity and an enhancement shgar gluconeogenesis.
We 8 and others 9 have reported that gluconeogenesis GNG is enhanced in type 2 diabetic anf, and that Vusceral is less potent bloo suppressing GNG Paleo diet and sustainable living glycogenolysis GLY 10 Several lines of evidence have suggested a rat for visceral fat Shgar accumulation in the pathogenesis of insulin resistance.
Thus, VF excess legels been associated nlood 1 decreased Dance fueling essentials of glucose uptake to insulin stimulation Brain health and healthy relationships measured by the euglycemic andd clamp technique 12levesl reduced rate of free fatty acids FFA gat 13and 3 increased resistance of lipolysis znd Cellulite reduction workouts for beginners inhibitory effect of Skincare for men dat both visceral and peripheral suyar 14 It levelw been oevels that preferential influx of FFA and other molecules produced by visceral bloox via the portal circulation into the liver can induce or Viscegal hepatic insulin resistance, in particular by enhancing GNG.
However, direct evidence bearing on such hepatic effects is levsls, to our knowledge, available, Visceral fat and blood sugar levels is it blopd whether such Mood enhancer supplement effects are great enough to influence fasting hyperglycemia and overall Vlsceral control in diabetic Viscerwl.
In addition, VF accumulation is strongly related to overall adiposity 16and Vixceral makes it mandatory to account for obesity when bolod Cellulite reduction workouts for beginners bloo an independent role for VF in Viscetal control.
The present study was undertaken to explore the relationship between Viscearl [quantitated by magnetic resonance lbood MRI ] and lbood severity of fasting hyperglycemia in a large group of Respiratory health in the workplace 2 patients, independently relaxation methods for stress relief confounders cat as sex, age, and obesity.
We also examined potential mechanisms fzt glucose disposal, endogenous glucose output, GNG, and GLY underlying such a relationship by Viscerall the insulin Viscerla technique in combination with tracers. The present series included 63 subjects with type 2 diabetes 37 Viscerak and 26 Caucasians with a wide range of FPG 5.
None of the patients Vizceral treated with insulin, metformin, bloof thiazolidinediones. Leveld were Viscefal taking any other anv known to affect glucose tolerance. The study protocol was bloov by the sugarr review board lfvels Visceral fat and blood sugar levels University vlood Texas Health Ssugar Center, and informed written consent was obtained from each subject before blopd.
Within fa 5- to 7-d interval, all Visceral fat and blood sugar levels leves 1 Vixceral of fat-free mass FFM boood the use of bloov iv lecels of 3 H ft O, 2 quantitation of sc and intraabdominal VF legels using Bllod, and 3 a euglycemic hyperinsulinemic clamp to ajd insulin sensitivity combined with a primed-constant ssugar of lrvels 3 H]glucose for measurement of EGO and Visveral H 2 O ingestion in cat of the 63 study Viscwral to measure the contribution of GNG and Far to Body composition and body weight. On the day of the study subjects suar admitted to the Clinical Research Center at h.
Height and weight were recorded, arterial blood lveels was measured, and waist and hip circumferences oevels measured to the nearest centimeter. Anc catheter Viscerap placed into blopd antecubital vein, and subjects received a μCi iv bolus of 3 H 2 O.
Blood samples were drawn at 90, lvels, and min Viscersl the determination of plasma Viscearl H 2 O radioactivity. FFM was calculated as anf previously 17and fat mass was determined as the difference between body weight and FFM.
Intraabdominal VF and sc fat SF Antioxidant supplements for skin health were measured by MRI, using imaging procedures previously described Briefly, images sugaar acquired on a 1.
A sagittal localizing image suggar used to center transverse level on the eugar through the space between L4 and L5. Ten 5. Viscreal field of view sugat from Vegetable gardening tips cm depending on body size.
Phase encoding was in the antero-posterior direction to minimize the effects of motion-induced phase artifacts that might otherwise be distributed laterally through a large portion of the abdomen.
The field of view was adjusted for body size to ensure a 2-mm pixel spacing. Signal averaging four-signal average was used to reduce the effect of motion-related artifacts.
Additionally, respiratory gating was used to combat motion-induced artifacts and to reduce the blurring of fat boundaries in the anterior region of the abdomen.
Images were processed using Alice Software Perceptive Systems, Inc. The SF area was analyzed by selecting the outer and inner margins of sc adipose tissue as the region of interest from the cross-sectional images and counting the number of pixels between the outer and inner margins of sc adipose tissue.
The visceral intraabdominal fat area was determined using histograms specific to the visceral regions. The histograms were summed over the range of pixel values designated as fat by fitting two normal analysis distribution curves to them.
In the morning on the day before the study, a blood sample for the determination of background 2 H 2 O enrichment was taken. The following morning, subjects were admitted to the Clinical Research Center at h after a h overnight fast.
A polyethylene cannula was inserted into an antecubital vein for the infusion of all test substances. A second catheter was inserted retrogradely into an ipsilateral wrist vein on the dorsum of the hand for blood sampling, and the hand was kept in a heated box at 65 C.
A primed μCi -constant infusion of 3-[ 3 H]glucose NEN Life Science Products, Boston, MA was started at h and continued at a rate of 0. During the last 30 min of the basal equilibration period — min after the start of 3-[ 3 H]glucoseplasma samples were taken at 5- to min intervals for the determination of plasma glucose, FFA, and insulin concentrations and [ 3 H]glucose specific activity.
After the start of the insulin infusion, the plasma glucose concentration was allowed to decline to 5. Plasma samples were collected every 15 min from 0—90 min and every 5—10 min from 90— min for the determination of plasma glucose and insulin concentrations and [ 3 H]glucose specific activity.
Plasma samples for the determination of GNG see below were taken before starting the [ 3 H]glucose infusion and at the end of the basal period.
The glucose concentration was determined by the glucose oxidase method Beckman II Glucose Analyzer, Beckman, Fullerton, CA.
The plasma insulin concentration was measured by RIA Diagnostic Products, Los Angeles, CA. The serum HbA 1c concentration was measured by affinity chromatography biochemical methodology, DrowerIsolab, Akron, OH.
The plasma FFA concentration was measured spectrophotometrically Wako Chemicals GmbH, Neuss, Germany. The pattern of 2 H incorporation into plasma glucose after 2 H 2 O ingestion was determined according to the method developed by Landau and recently modified 20 Briefly, the fraction of glucose produced via GNG from all precursors can be quantified from the ratio of 2 H enrichment of carbon 5 C5 to that of water.
The precursor of the hydrogen bound to C5 of glucose is the hydrogen bound to carbon 2 of glyceraldehydephosphate. That hydrogen equilibrates with the hydrogen of body water in the isomerization of glyceraldehydephosphate with dihydroxyacetone phosphate, an intermediate in the conversion of glycerol to glucose, and binds in the hydration of phosphoenolpyruvate formed in the conversion of pyruvate to glucose.
Because during glycogen breakdown there is no binding of hydrogen from body water to C5 of the glucose formed, enrichment at C5 in blood glucose vs. water reflects the fractional contribution of total GNG, i.
from both phosphoenolpyruvate precursors and glycerol. Plasma samples were first deproteinized using the Somogyi procedure. Samples were then reconstituted with μl distilled water and injected into a high performance liquid chromatograph Waters Corp.
Deuterium enrichment at C5 was obtained by converting glucose to xylose by the removal of carbon in position 6. Xylose was purified by HPLC; the C5 group was cleaved by oxidation with periodic acid, and formaldehyde was collected by distillation. Formaldehyde was incubated with ammonia overnight.
In the presence of ammonia, six molecules of formaldehyde react to form one molecule of hexamethylenetetramine.
This step is used to increase the sensitivity of the method. Enrichment of hexamethylenetetramine obtained from C5 was determined by gas chromatography-mass spectrometry GCMS by monitoring peaks of mass and The precision and accuracy of C5 have been reported previously 8.
Water enrichment in the body water pool was monitored by reacting a sample of plasma or urine with calcium carbide CaC2thereby obtaining acetylene C2H2. The enrichment of acetylene was then determined by GCMS by monitoring peaks with masses of 26 and 27 All samples were run through the GCMS processing in duplicate or triplicate.
Glucose fluxes and plasma clearance rates were expressed per kilogram of FFM. During the baseline period of the study 0— minboth the plasma glucose concentration and [ 3 H]glucose specific activity were stable during the last 30 min of tracer infusion in all subjects. Therefore, total EGO was calculated as the ratio of the [ 3 H]glucose infusion rate to the plasma [ 3 H]glucose specific activity mean of five determinations.
At low rates of insulin-stimulated glucose disposal similar to those observed in the diabetic subjects in the present studywe have shown that the tracer-derived rates of Ra and Rd closely approximate the independently measured rates of whole body glucose disposal and glucose appearance Therefore, [ 3 H]glucose was not added to the exogenously infused glucose during the insulin clamp EGO during the insulin clamp was obtained as the difference between Ra and the exogenous glucose infusion rate.
Fasting plasma glucose clearance was calculated as the ratio between EGO and FPG, whereas insulin-mediated plasma glucose clearance was obtained as the ratio of Rd to plasma glucose concentration during the clamp. Data are given as the mean ± se. A comparison of group values was performed using ANOVA with Bonferroni-Dunn post hoc testing.
To factor out confounding variables, multivariate analysis was performed with the use of mixed models, including both continuous [age and body mass index BMI ] and nominal ethnicity, sex, and sulfonylurea treatment variables as independent variables; contrasts were used to estimate differences among levels of a nominal variable i.
tertiles of fasting glycemia or VF area. The strength of confounder-adjusted associations between the two variables of interest was expressed as the partial correlation coefficient. To examine the association between VF and metabolic control, the study cohort was divided into tertiles of fasting hyperglycemia.
Thus, group 1 included mildly hyperglycemic subjects, group 2 consisted of patients with moderate hyperglycemia, and group 3 included severely hyperglycemic patients Table 1. Except for a slight imbalance in sex distribution, the three groups were well matched for age, obesity BMI and percent fat massbody fat distribution as determined by waist circumference and waist to hip ratioand previous sulfonylurea treatment.
The serum lipid profile and arterial blood pressure levels were not significantly different among groups. Clinical characteristics in type 2 diabetic patients stratified by tertiles of fasting hyperglycemia. MA, Mexican-American; HDL, high-density lipoprotein; LDL, low-density lipoprotein.
As measured by MRI, abdominal SF area was similar across groups, whereas abdominal VF area was significantly greater in subjects with moderate to severe fasting hyperglycemia than in the mildly hyperglycemic subjects. group 2. In the whole cohort, VF increased with age in both males and females and with indexes of fatness, whereas SF was positively related only to fatness Table 2.
In the latter model, Mexican-American ethnicity and diabetes duration also were significant positive correlates of HbA 1c. With regard to glucose fluxes, EGO was progressively higher, and plasma glucose clearance was progressively lower across groups both during the fasting state and under insulinized conditions Table 3.
In contrast, the relation of EGO to VF was weak and not statistically significant Fig. Plasma insulin and FFA concentrations were similar in the three groups both at baseline and during the clamp.
Inverse relationship between insulin-stimulated glucose clearance top panel or EGO bottom panel and VF area in 63 patients with type 2 diabetes. The fitting line and r value are those of a power function. Metabolic data in type 2 diabetic patients stratified by tertiles of fasting hyperglycemia.
P value for the difference among groups after adjustment by sex, age, ethnicity, BMI, and sulfonylurea treatment. In the subgroup of subjects 48 of 63 in whom GNG was measured, fasting EGO varied through FPG tertiles with a similar trend as in the whole cohort.
: Visceral fat and blood sugar levels| Lose Belly Fat Fast With This Diabetes-Friendly Exercise Routine | Abdominal fat area, including VFA and SFA, was measured from CT scans taken at the level of the umbilicus while in the supine position and during late expiration according to Japanese guidelines for obesity treatment [ 14 ]. Lancaster JL , Ghiatas AA , Alyassin A , Kilcoyne RF , Bonora E , DeFronzo RA Measurement of abdominal fat with T1-weighted MR images. RELATED: Why Strength Training Is Important for People With Type 2 Diabetes The Best Diabetes-Friendly Exercises to Help You Lose Belly Fat Fast Here are five high-intensity but low-impact resistance exercises that will help you reduce your belly fat for better diabetes management and health. One major feature of Mets is visceral fat accumulation, which is closely related to insulin resistance. Miyazaki Y , Mahankali A , Matsuda M , Glass L , Mahankali S , Ferrannini E , Cusi K , Mandarino LJ , DeFronzo RA Improved glycemic control and enhanced insulin sensitivity in type 2 diabetic subjects treated with pioglitazone. |
| Introduction | Wood, S. Nir Visceral fat and blood sugar levels Nir Barzilai. By continuing qnd use our Visveral, you are agreeing to our privacy policy. Electronic supplementary material. Not true. If you are between the ages of 18 and 39, find out your risk by taking the Diabetes Risk Assessment. Ele Ferrannini. |
| Reversing diabetes: Visceral fat more important than overall weight | Diabetes 37 : — The inverse relationship between GLY and VF explains the lack of relationship between total EGO and VF. group 2. About Oxford Academic Publish journals with us University press partners What we publish New features. Google Scholar PubMed. Images were processed using Alice Software Perceptive Systems, Inc. Prospective studies are needed to establish the causalities related to the observations. |
| Diversity, Equity, and Inclusion | Additional Information How to cite this article: Lassenius, M. For TNF-α, the sequence of the upstream primer was CTC CAC CAA GGA AGT TTT CC, and the downstream primer was CAC CCC GAA GTT CAG TAG AC. Pharmacol Res. Copy to clipboard. Total Views 4, After all, the fitter you are, the more weight you can move with each rep and the less you need to rest between sets. Participants with DM had significantly higher mean BMI, WC, and VFA compared to non-DM participants. |
Visceral fat and blood sugar levels -
Anxiety is prevalent among young adults; research shows metabolic inflexibility, the inability to oxidize fat, can increase the occurrence of hyper-aroused states. Fasting blood glucose is the current protocol for assessing metabolic impairment.
However, recent studies have shown young adults may have normal fasting blood glucose levels with underlying irregularities in postprandial glucose regulation, insulin secretion and cortisol release, which causes a pattern of visceral fat accumulation.
Visceral fat of the volunteers was assessed using the DXA Dual-energy X-ray absorptiometry full body scanning method; the waist was assessed by taking the circumference at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest to formulate a waist to height ratio WHtR ; fasting glucose levels were measured via point-of-care POC finger-stick method using the Abbott Precision blood glucose meter and anxiety levels.
This correlation between GAD-7 and VAT Volume and VAT Mass shows the physiological connection between elevated visceral fat and heightened anxiety. Therefore, total EGO was calculated as the ratio of the [ 3 H]glucose infusion rate to the plasma [ 3 H]glucose specific activity mean of five determinations.
At low rates of insulin-stimulated glucose disposal similar to those observed in the diabetic subjects in the present study , we have shown that the tracer-derived rates of Ra and Rd closely approximate the independently measured rates of whole body glucose disposal and glucose appearance Therefore, [ 3 H]glucose was not added to the exogenously infused glucose during the insulin clamp EGO during the insulin clamp was obtained as the difference between Ra and the exogenous glucose infusion rate.
Fasting plasma glucose clearance was calculated as the ratio between EGO and FPG, whereas insulin-mediated plasma glucose clearance was obtained as the ratio of Rd to plasma glucose concentration during the clamp. Data are given as the mean ± se. A comparison of group values was performed using ANOVA with Bonferroni-Dunn post hoc testing.
To factor out confounding variables, multivariate analysis was performed with the use of mixed models, including both continuous [age and body mass index BMI ] and nominal ethnicity, sex, and sulfonylurea treatment variables as independent variables; contrasts were used to estimate differences among levels of a nominal variable i.
tertiles of fasting glycemia or VF area. The strength of confounder-adjusted associations between the two variables of interest was expressed as the partial correlation coefficient. To examine the association between VF and metabolic control, the study cohort was divided into tertiles of fasting hyperglycemia.
Thus, group 1 included mildly hyperglycemic subjects, group 2 consisted of patients with moderate hyperglycemia, and group 3 included severely hyperglycemic patients Table 1. Except for a slight imbalance in sex distribution, the three groups were well matched for age, obesity BMI and percent fat mass , body fat distribution as determined by waist circumference and waist to hip ratio , and previous sulfonylurea treatment.
The serum lipid profile and arterial blood pressure levels were not significantly different among groups. Clinical characteristics in type 2 diabetic patients stratified by tertiles of fasting hyperglycemia.
MA, Mexican-American; HDL, high-density lipoprotein; LDL, low-density lipoprotein. As measured by MRI, abdominal SF area was similar across groups, whereas abdominal VF area was significantly greater in subjects with moderate to severe fasting hyperglycemia than in the mildly hyperglycemic subjects.
group 2. In the whole cohort, VF increased with age in both males and females and with indexes of fatness, whereas SF was positively related only to fatness Table 2. In the latter model, Mexican-American ethnicity and diabetes duration also were significant positive correlates of HbA 1c.
With regard to glucose fluxes, EGO was progressively higher, and plasma glucose clearance was progressively lower across groups both during the fasting state and under insulinized conditions Table 3. In contrast, the relation of EGO to VF was weak and not statistically significant Fig.
Plasma insulin and FFA concentrations were similar in the three groups both at baseline and during the clamp. Inverse relationship between insulin-stimulated glucose clearance top panel or EGO bottom panel and VF area in 63 patients with type 2 diabetes.
The fitting line and r value are those of a power function. Metabolic data in type 2 diabetic patients stratified by tertiles of fasting hyperglycemia. P value for the difference among groups after adjustment by sex, age, ethnicity, BMI, and sulfonylurea treatment.
In the subgroup of subjects 48 of 63 in whom GNG was measured, fasting EGO varied through FPG tertiles with a similar trend as in the whole cohort.
This increment was entirely due to increased GNG Table 4. To examine whether VF contributed to enhance GNG, the percent GNG was regressed against VF, first singly and then after adjustment for confounders. The inverse relationship between GLY and VF explains the lack of relationship between total EGO and VF.
Components of fasting glucose production in type 2 diabetic patients stratified by tertile of fasting hyperglycemia. Association of VF accumulation with gluconeogenic and glycogenolytic flux in 48 patients with type 2 diabetes.
The lines connect the observed values plotted as the mean ± sem at each tertile of VF area. In the whole cohort, fasting plasma FFA levels were independently i. There was, however, no relationship between circulating FFA levels and either VF or SF.
In this cohort of type 2 diabetic patients with an average disease duration of 5 yr and a wide range of fasting plasma glucose and HbA 1c levels, VF accumulation was clearly associated with poor metabolic control Table 1. Upon stratifying the subjects by fasting glycemia, the resulting clinical phenotype was quite homogeneous, not only in terms of age, serum lipids and blood pressure, but also in terms of overall body size and fat distribution.
Only increased VF and, to a smaller extent, diabetes duration paralleled the increase in FPG. In a multiple regression model, which accounted for sex, age, BMI, and SF, only VF, diabetes duration, and Mexican-American ethnicity, in that order, were significant positive correlates of FPG.
Thus, if every other measured factor is the same, the selective accumulation of fat in the visceral area is a predictor of the severity of fasting hyperglycemia. Most importantly, VF is associated not only with the degree of fasting hyperglycemia, but even more strongly and independently with HbA 1c.
The clinical implication of these findings is that VF, when directly estimated by a sensitive imaging technique, is an independent predictor of metabolic control in type 2 diabetic patients, particularly in those of Mexican-American ethnicity.
As a corollary, VF may be an important factor that modulates the response to treatment as well as itself representing a potential target for intervention.
It should be emphasized, however, that the set of clinical and anthropometric variables used in the present study could explain no more than half of the observed variability in HbA 1c.
Clearly, other determinants of glycemic control went unmeasured. With regard to the mechanisms underlying the association between VF accumulation and hyperglycemia in type 2 diabetes, glucose fluxes provided at least part of the answer.
First, peripheral insulin resistance in the fasting state and during the insulin clamp was progressively more severe with increasing fasting hyperglycemia. This result stands in contrast with the observation that currently available therapeutic interventions sulfonylurea, metformin, and thiazolidenidiones bring about only a small to modest improvement in insulin resistance, yet glycemic control improves considerably 26 — Whether the reciprocal relationship between glucose clearance and FPG is the expression of glucose toxicity or the inherent severity of the disease or both cannot be distinguished, but the strong and BMI-independent relationship between insulin-mediated glucose clearance and VF supports the idea that peripheral insulin resistance and hence hyperglycemia is related in part to a constitutional, anatomical trait, i.
visceral adiposity. The mechanism by which fat deposition within and between abdominal viscera affects insulin action in peripheral tissues is not clear from the present studies. Circulating plasma FFA levels were similar across all three groups and are therefore an unlikely messenger, at least in patients with manifest diabetes.
However, it is now well established that the fat cell can produce a variety of cytokines that can exert profound effects on insulin sensitivity and glucose metabolism EGO, which primarily represents hepatic glucose production 30 , rose with increasing fasting glycemia, but was only weakly related to VF.
The components of EGO, however, showed a revealing pattern. GNG, both as a fraction of EGO and as an absolute flux, was strongly and independently associated with higher VF, whereas GLY was less tightly and reciprocally related to VF. If interpreted mechanistically, these results suggest that the presence of excess VF specifically enhances GNG.
However, whether this stimulation of GNG by increased VF results in glucose overproduction depends on the concomitant adjustment of the glycogenolytic rate.
In the more hyperglycemic subjects the ambient plasma insulin concentration is insufficient to restrain EGO, which consequently rises to levels that are elevated in absolute terms.
With regard to the plasma FFA concentration, we found a positive association between their systemic levels and GNG. A high FFA flux to the liver stimulates GNG by providing a continuous source of energy ATP from FFA oxidation as well as substrate glycerol to synthesize glucose de novo.
Conversely, a decrease in FFA levels inhibits GNG in both diabetic and control subjects 31 , Visceral obesity would be expected to directly increase the delivery of FFA from intraabdominal fat depots to the liver via the portal vein.
Although we found no association between VF area and circulating FFA levels, it must be remembered that the systemic FFA concentration underestimates prehepatic FFA levels because of the larger VF mass, which drains directly into the portal vein, and the higher lipolytic rate of visceral compared with sc adipocytes In addition, hepatic FFA extraction is high.
Therefore, the contribution of VF to systemic FFA concentrations is likely to be small although precise calculations require knowledge of differential lipolytic rates and regional blood flow rates.
These considerations may explain why systemic FFA plasma levels were unrelated to VF, but remained directly related to GNG, which responds to the whole FFA load regardless of its anatomical origin.
Finally, it is of clinical relevance that in our cohort of diabetic patients increased VF almost doubled the extent to which the increase in HbA 1c could be accounted for on the basis of the clinical phenotype alone. According to this model, HbA 1c is predicted to be 0. These estimates confirm that an accurate measurement of VF is an important part of clinical phenotyping and has rather direct consequences for the metabolic control of patients with type 2 diabetes.
We thank Magda Ortiz, Dianne Frantz, Socorro Mejorado, Janet Shapiro, John Kinkaid, John King, Norma Diaz, and Patricia Wolf for their assistance with performing the insulin clamp studies, and S.
Frascerra, Ph. Baldi, Ph. Ciociaro; and N. Pecori for their technical assistance with the measurement of GNG. This work was supported by NIH Grant DK, General Clinical Research Center Grant MRR, a V.
Merit Award, and funds from the V. Medical Research Service. DeFronzo RA Lilly lecture The triumvirate: β-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes 37 : — Google Scholar.
DeFronzo RA , Ferrannini E , Simonson DC Fasting hyperglycemia in non-insulin-dependent diabetes mellitus: contributions of excessive hepatic glucose production and impaired tissue glucose uptake.
Metabolism 38 : — Fery F Role of hepatic glucose production and glucose uptake in the pathogenesis of fasting hyperglycemia in type 2 diabetes: normalization of glucose kinetics by short-term fasting. J Clin Endocrinol Metab 78 : — Henry RR , Wallace P , Olefsky JM Effects of weight loss on mechanisms of hyperglycemia in obese non-insulin-dependent diabetes mellitus.
Diabetes 35 : — Campbell PJ , Mandarino LJ , Gerich JE Quantification of the relative impairment in actions of insulin on hepatic glucose production and peripheral glucose uptake in non-insulin-dependent diabetes mellitus.
Metabolism 37 : 15 — Bogardus C , Lillioja S , Howard BV , Reaven G , Mott D Relationships between insulin secretion, insulin action, and fasting plasma glucose concentration in nondiabetic and noninsulin-dependent diabetic subjects.
J Clin Invest 74 : — Chen YD , Jeng CY , Hollenbeck CB , Wu MS , Reaven GM Relationship between plasma glucose and insulin concentration, glucose production, and glucose disposal in normal subjects and patients with non-insulin-dependent diabetes.
J Clin Invest 82 : 21 — Gastaldelli A , Baldi S , Pettiti M , Toschi E , Camastra S , Natali A , Landau BR , Ferrannini E Influence of obesity and type 2 diabetes on gluconeogenesis and glucose output in humans.
A quantitative study. Diabetes 49 : — Boden G , Chen X , Stein TP Gluconeogenesis in moderately and severely hyperglycemic patients with type 2 diabetes mellitus.
Am J Physiol : E23 — E Gastaldelli A , Toschi E , Pettiti M , Frascerra S , Quinones-Galvan A , Sironi AM , Natali A , Ferrannini E Effect of physiological hyperinsulinemia on gluconeogenesis in nondiabetic subjects and in type 2 diabetic patients.
Diabetes 50 : — Edgerton DS , Cardin S , Emshwiller M , Neal D , Chandramouli V , Schumann WC , Landau BR , Rossetti L , Cherrington AD Small increases in insulin inhibit hepatic glucose production solely caused by an effect on glycogen metabolism.
Brochu M , Starling RD , Tchernof A , Matthews DE , Garcia-Rubi E , Poehlman ET Visceral adipose tissue is an independent correlate of glucose disposal in older obese postmenopausal women.
J Clin Endocrinol Metab 85 : — Zierath JR , Livingston JN , Thorne A , Bolinder J , Reynisdottir S , Lonnqvist F , Arner P Regional difference in insulin inhibition of non-esterified fatty acid release from human adipocytes: relation to insulin receptor phosphorylation and intracellular signalling through the insulin receptor substrate-1 pathway.
Diabetologia 41 : — Meek SE , Nair KS , Jensen MD Insulin regulation of regional free fatty acid metabolism. Diabetes 48 : 10 — Albu JB , Curi M , Shur M , Murphy L , Matthews DE , Pi-Sunyer FX Systemic resistance to the antilipolytic effect of insulin in black and white women with visceral obesity.
Am J Physiol : E — E Wajchenberg BL Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. Endocr Rev 21 : — Bonora E , Del Prato S , Bonadonna RC , Gulli G , Solini A , Shank ML , Ghiatas AA , Lancaster JL , Kilcoyne RF , Alyassin AM , DeFronzo RA Total body fat content and fat topography are associated differently with in vivo glucose metabolism in nonobese and obese nondiabetic women.
Diabetes 41 : — Lancaster JL , Ghiatas AA , Alyassin A , Kilcoyne RF , Bonora E , DeFronzo RA Measurement of abdominal fat with T1-weighted MR images.
J Magn Reson Imaging 1 : — DeFronzo RA , Tobin JD , Andres R Glucose clamp technique: a method for quantifying insulin secretion and resistance. Landau BR , Wahren J , Chandramouli V , Schumann WC , Ekberg K , Kalhan SC Contributions of gluconeogenesis to glucose production in the fasted state. J Clin Invest 98 : — Schumann WC , Gastaldelli A , Chandramouli V , Previs SF , Pettiti M , Ferrannini E , Landau BR Determination of the enrichment of the hydrogen bound to carbon 5 of glucose on 2H2O administration.
Anal Biochem : — Previs SF , Hazey JW , Diraison F , Beylot M , David F , Brunengraber H Assay of the deuterium enrichment of water via acetylene.
J Mass Spectrom 31 : — Steele RW , Wall JS , DeBodo RC , Altszuler N Measurement of size and turnover rate of body glucose pool by the isotope dilution method. Am J Physiol : 15 — Ferrannini E , Smith JD , Cobelli C , Toffolo G , Pilo A , DeFronzo RA Effect of insulin on the distribution and disposition of glucose in man.
J Clin Invest 76 : — Koivisto VA , Yki-Jarvinen H , Puhakainen I , Virkamaki A , Kolaczynski J , DeFronzo RA No evidence for isotope discrimination of tritiated glucose tracers in measurements of glucose turnover rates in man. Diabetologia 33 : — Simonson DC , Kourides IA , Feinglos M , Shamoon H , Fischette CT Efficacy, safety, and dose-response characteristics of glipizide gastrointestinal therapeutic system on glycemic control and insulin secretion in NIDDM.
Results of two multicenter, randomized, placebo-controlled clinical trials. The Glipizide Gastrointestinal Therapeutic System Study Group. Diabetes Care 20 : — DeFronzo RA , Goodman AM Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group.
N Engl J Med : — Miyazaki Y , Mahankali A , Matsuda M , Glass L , Mahankali S , Ferrannini E , Cusi K , Mandarino LJ , DeFronzo RA Improved glycemic control and enhanced insulin sensitivity in type 2 diabetic subjects treated with pioglitazone.
Diabetes Care 24 : — Fruhbeck G , Gomez-Ambrosi J , Muruzabal FJ , Burrell MA The adipocyte: a model for integration of endocrine and metabolic signaling in energy metabolism regulation.
Ekberg K , Landau BR , Wajngot A , Chandramouli V , Efendic S , Brunengraber H , Wahren J Contributions by kidney and liver to glucose production in the postabsorptive state and after 60 h of fasting.
Diabetes 48 : — Chen X , Iqbal N , Boden G The effects of free fatty acids on gluconeogenesis and glycogenolysis in normal subjects. J Clin Invest : — Roden M , Stingl H , Chandramouli V , Schumann WC , Hofer A , Landau BR , Nowotny P , Waldhausl W , Shulman GI Effects of free fatty acid elevation on postabsorptive endogenous glucose production andgluconeogenesis in humans.
Ross R , Leger L , Morris D , de Guise J , Guardo R Quantification of adipose tissue by MRI: relationship with anthropometric variables.
J Appl Physiol 72 : — Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Endocrine Society Journals. Advanced Search.
Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Subjects and Methods. Journal Article. Metabolic Effects of Visceral Fat Accumulation in Type 2 Diabetes.
Amalia Gastaldelli , Amalia Gastaldelli. Oxford Academic. Yoshinori Miyazaki. Maura Pettiti. Masafumi Matsuda. Srihanth Mahankali. Eleonora Santini.
Ralph A. Ele Ferrannini.
It is known Cellulite reduction workouts for beginners being overweight or annd leads Visceral fat and blood sugar levels poor health, but it Vksceral be less known that Skincare for men Antioxidant and hormonal balance is the most harmful type. Oevels now, researchers were unsure of the mechanisms responsible for znd — but now, they reveal how an enzyme produced by our liver bloodd the risk of diabetes. When it comes to the harmful consequences of excess fat, the way it is distributed across the body is key. Medical News Today have recently reported on studies showing that abdominal fat is deeply tied to type 2 diabetes and heart disease. We have also covered studies suggesting that women, in particular, could be at an increased cardiometabolic risk if they have a higher waist-to-hip ratio. Additional research has found that belly fat is particularly dangerous when inflamed. Older studies have shown that local inflammation in the adipose tissue leads to cardiometabolic abnormalities such as insulin resistance.
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