Deterioration of the Metabolic Risk Profile in Women
Respective contributions of impaired glucose tolerance and visceral fat accumulation
- Agnés Pascot, MSC12,
- Jean-Pierre Després, PHD123,
- Isabelle Lemieux, MSC12,
- Natalie Alméras, PHD12,
- Jean Bergeron, MD, MSC1,
- André Nadeau, MD3,
- Denis Prud’homme, MD, MSC14,
- Angelo Tremblay, PHD4 and
- Simone Lemieux, PHD15
- 1Lipid Research Center, CHUQ Research Center
- 2Quebec Heart Institute, Hospital Laval Research Center
- 3Diabetes Research Unit, CHUQ Research Center
- 4Division of Kinesiology, Department of Preventive and Social Medicine
- 5Department of Food Science and Nutrition, Laval University, Ste-Foy, Québec, Canada
Abstract
OBJECTIVE—To determine whether the impaired glucose tolerance (IGT) state contributes to the deterioration of the metabolic profile in women after taking into account the contribution of visceral adipose tissue (AT) accumulation, as measured by computed tomography.
RESEARCH DESIGN AND METHODS—We studied 203 women with normal glucose tolerance (NGT) and 46 women with IGT, defined as a glycemia between 7.8 and 11.1 mmol/l measured 2 h after a 75-g oral glucose load.
RESULTS—Women with IGT were characterized by a higher visceral AT accumulation and by higher concentrations of fasting plasma glucose, insulin, and C-peptide as well as by higher plasma concentrations of cholesterol, triglycerides, and apolipoprotein B (apoB) and by greater cholesterol–to–HDL-cholesterol ratio, reduced LDL peak particle size, lower HDL-cholesterol and HDL2-cholesterol concentrations, and higher blood pressure (P < 0.01) than women with NGT. When we matched 27 pairs of women for visceral AT and fat mass as well as for menopausal status, differences previously found in LDL-cholesterol, LDL peak particle size, HDL-cholesterol, and HDL2-cholesterol concentrations as well as in the cholesterol–to–HDL-cholesterol ratio and blood pressure were eliminated, whereas triglyceride concentrations remained significantly higher in women with IGT.
CONCLUSIONS—A high visceral AT accumulation is a major factor involved in the deterioration of many metabolic variables in women with IGT, with the notable exception of triglyceride concentrations, which remained significantly different between women with NGT and women with IGT after adjustment for visceral fat.
- apo, apolipoprotein
- AT, adipose tissue
- CVD, cardiovascular disease
- HRT, hormone replacement therapy
- IGT, impaired glucose tolerance
- NGT, normal glucose tolerance
- OGTT, oral glucose tolerance test
- SHBG, sex hormone–binding globulin.
Footnotes
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Address correspondence and reprint requests to Simone Lemieux, PhD, Department of Food Science and Nutrition, Laval University, Paul-Comtois Pavilion, Sainte-Foy (Québec), CANADA G1K 7P4. E-mail: simone.lemieux{at}aln.ulaval.ca.
Received for publication 19 October 2000 and accepted in revised form 6 February 2001.
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