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Diabetes Care 26:2341-2344, 2003
© 2003 by the American Diabetes Association, Inc.


Epidemiology/Health Services/Psychosocial Research
Original Article

Increased Visceral Fat and Serum Levels of Triglyceride Are Associated With Insulin Resistance in Japanese Metabolically Obese, Normal Weight Subjects With Normal Glucose Tolerance

Akira Katsuki, MD1, Yasuhiro Sumida, MD1, Hideki Urakawa, MD1, Esteban C. Gabazza, MD1, Shuichi Murashima, MD2, Noriko Maruyama, MD1, Kohei Morioka, MD1, Kaname Nakatani, MD3, Yutaka Yano, MD1 and Yukihiko Adachi, MD1

1 Third Department of Internal Medicine, Mie University School of Medicine, Mie, Japan
2 Department of Radiology, Mie University School of Medicine, Mie, Japan
3 Department of Laboratory Medicine, Mie University School of Medicine, Mie, Japan

Address correspondence and reprint requests to Yasuhiro Sumida, MD, Third Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. E-mail: sumidaya{at}clin.medic.mie-u.ac.jp

OBJECTIVE—The purpose of this study was to investigate the association between visceral adiposity or triglyceride (TG) metabolism and insulin resistance in metabolically obese, normal weight (MONW) Japanese individuals with normal glucose tolerance.

RESEARCH DESIGN AND METHODS—We evaluated body fat areas, lipid profiles, and the glucose infusion rate (GIR) during a euglycemic-hyperinsulinemic clamp study in 20 MONW subjects (BMI <25 kg/m2and visceral fat areas 100 cm2) with normal glucose tolerance. Body fat areas were measured by computed tomography scans. Control data were obtained from 20 normal subjects (BMI <25 kg/m2 and visceral fat areas <100 cm2).

RESULTS—MONW subjects showed a significant increase in fasting serum levels of TG (P < 0.01) and a decrease in GIR (P < 0.01) compared with normal subjects. There were significant correlations between visceral fat areas (r = -0.563, P < 0.01) or serum levels of TG (r = -0.474, P < 0.05) and GIR in MONW subjects. Multiple regression analyses showed that visceral fat areas (F = 7.702, P < 0.02) and serum levels of TG (F = 7.114, P < 0.05) were significantly associated with GIR in all (MONW and normal) subjects.

CONCLUSIONS—Increased visceral fat and serum levels of TG are associated with insulin resistance in Japanese MONW subjects with normal glucose tolerance. Excess visceral fat and elevated TG levels may play important roles in the development of insulin resistance in Japanese MONW subjects with normal glucose tolerance.

Abbreviations: AUC, area under the curve • GIR, glucose infusion rate • MONW, metabolically obese, normal weight • TG, triglyceride


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