Relation of Abdominal Fat Depots to Systemic Markers of Inflammation in Type 2 Diabetes

Abstract

Objective: Both Visceral (VAT) and subcutaneous abdominal fat (SAT) have been linked to systemic inflammation in non-diabetic cohorts. We examined the relationships between VAT and SAT, and systemic inflammatory markers in a large well-characterized cohort with type 2 diabetes.

Research Design and Methods: Three hundred eighty two subjects with type 2 diabetes in the CHICAGO cohort underwent abdominal computed tomography to determine SAT and VAT distribution. Fasting blood was obtained for measurement of inflammatory markers. The relationships between inflammatory markers and BMI, SAT and VAT were examined using regression models adjusted for age, sex, diabetes treatment, duration of diabetes, smoking, statin use and hemoglobin A1c.

Results: VAT was positively related to CRP, MCP, ICAM-1 and PAI-1 antigen before adjustment for BMI. After adjustment for BMI, the relationship to CRP was lost but positive associations with MCP (P<0.01), PAI-1 (P<0.0001), ICAM-1 (P<0.01) and VCAM (P=0.01) were evident. BMI was positively related to CRP (P<0.0001) and IL-6 (P<0.01) even after adjustment for VAT and SAT. SAT was not related to any inflammatory marker after adjustment for BMI.

Conclusions: In this large group of subjects with type 2 diabetes, BMI was most strongly associated with CRP and LL-6 levels. SAT was not associated with markers of systemic inflammation. The size of the VAT depot provided information additional to that provided by BMI regarding inflammatory markers that are strongly related to vascular wall remodeling and coagulation. Our findings suggest that adipose tissue distribution remains an important determinant of systemic inflammation in type 2 diabetes.