title: Association between regional adipose tissue distribution and both type 2 diabetes and impaired glucose tolerance in elderly men and women.
abstract: OBJECTIVE
  We examined whether regional adipose tissue distribution, specifically that of skeletal muscle fat and visceral abdominal fat aggregation, is characteristic of elderly individuals with hyperinsulinemia, type 2 diabetes, and impaired glucose tolerance (IGT).
  
  
  METHODS
  A total of 2,964 elderly men and women (mean age 73.6 years) were recruited for cross-sectional comparisons of diabetes or glucose tolerance, generalized obesity with dual-energy X-ray absorptiometry, and regional body fat distribution with computed tomography. RESULTS-Approximately one-third of men with type 2 diabetes and less than half of women with type 2 diabetes were obese (BMI > or =30 kg/m(2)). Despite similar amounts of subcutaneous thigh fat, intermuscular fat was higher in subjects with type 2 diabetes and IGT than in subjects with normal glucose tolerance (NGT) (11.2 +/- 9.4, 10.3 +/- 5.8, and 9.2 +/- 5.9 cm(2) for men; 12.1 +/- 6.1, 10.9 +/- 6.5, and 9.4 +/- 5.3 cm(2) for women; both P < 0.0001). Visceral abdominal fat was also higher in men and women with type 2 diabetes and IGT than in subjects with NGT (172 +/- 79, 163 +/- 72, and 145 +/- 66 cm(2) for men; 162 +/- 66, 141 +/- 60, and 116 +/- 54 cm(2) for women; both P < 0.0001 across groups). Higher rates of intermuscular fat and visceral abdominal fat were associated with higher fasting insulin in normal-weight (BMI <25 kg/m(2)) men (r = 0.24 for intermuscular fat, r = 0.37 for visceral abdominal fat, both P < 0.0001) and women (r = 0.20 for intermuscular fat, r = 0.40 for visceral abdominal fat, both P < 0.0001). These associations were not found in obese subjects.
  
  
  CONCLUSIONS
  Elderly men and women with normal body weight may be at risk for metabolic abnormalities, including type 2 diabetes, if they possess an inordinate amount of muscle fat or visceral abdominal fat.
authors.affiliation: Department of Medicine, University of Pittsburgh Medical Center, Pennsylvania 15213, USA. bgood@pitt.edu
authors.forename: Bret H
authors.initials: BH
authors.lastname: Goodpaster
authors.forename: Shanthi
authors.initials: S
authors.lastname: Krishnaswami
authors.forename: Helaine
authors.initials: H
authors.lastname: Resnick
authors.forename: David E
authors.initials: DE
authors.lastname: Kelley
authors.forename: Catherine
authors.initials: C
authors.lastname: Haggerty
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Ann V
authors.initials: AV
authors.lastname: Schwartz
authors.forename: Steven
authors.initials: S
authors.lastname: Kritchevsky
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
mesh_terms: D000005:Abdomen; D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000000981:diagnostic imaging*; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000000981:diagnostic imaging*; D006801:Humans; D007328:Insulin / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D014057:Tomography, X-Ray Computed; D014781:Viscera
chemical_list: D007328:Insulin