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Impaired Postprandial Blood Flow in Adipose Tissue May Be an Early Marker of Insulin Resistance in Type 2 Diabetes

¹ 2nd Department of Internal Medicine—Propaedeutic and Research Institute, Athens University Medical School, "Attikon" University Hospital Athens, Greece
² Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), Athens, Greece
³ Nutrition Science-Dietetics, Harokopio University, Athens, Greece

Address correspondence and reprint requests to George Dimitriadis, MD, Internal Medicine, Athens University, "Attikon" University Hospital, 1 Rimini St., GR-12462 Haidari, Greece. E-mail: gdimi{at}ath.forthnet.gr and gdimitr{at}med.uoa.gr

OBJECTIVE—We investigated the changes in subcutaneous adipose tissue blood flow (ATBF) after a meal in the various stages of type 2 diabetes.

RESEARCH DESIGN AND METHODS—Five groups were examined: healthy control subjects, first-degree relatives of subjects with type 2 diabetes, subjects with impaired glucose tolerance (IGT), subjects with type 2 diabetes and postprandial hyperglycemia but normal fasting plasma glucose levels (diabetes group A [DMA]), and subjects with type 2 diabetes with both postprandial and fasting hyperglycemia (diabetes group B [DMB]). ATBF was measured with ¹³³Xe.

RESULTS—ATBF was higher in control subjects (1,507 ± 103 ml/100 cm³ tissue x min) versus relatives and IGT, DMA, and DMB subjects (845 ± 123, 679 ± 69, 765 ± 60, and 757 ± 69 ml/100 cm³ tissue x min, respectively; P < 0.001). Insulin sensitivity index (ISI) in control subjects (82 ± 3 mg x l²/mmol x mU x min) was higher versus that for relatives and IGT, DMA, and DMB subjects (60 ± 3, 45 ± 1, 40 ± 6, and 29 ± 4 mg x l²/mmol x mU x min, respectively; P < 0.0001). ISI was positively associated with peak-baseline ATBF (β coefficient 0.029 ± 0.013, P = 0.03).

CONCLUSIONS—After meal ingestion, insulin-stimulated ATBF was decreased in relatives and and IGT, DMA, and DMB subjects. This defect could be an early marker of insulin resistance that precedes the development of type 2 diabetes.

Abbreviations: ATBF, adipose tissue blood flow • IGT, impaired glucose tolerance • ISI, insulin sensitivity index • NEFA, nonesterified fatty acids

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