Insulin action, regional fat, and myocyte lipid: altered relationships with increased adiposity.
OBJECTIVE
Abdominal fat and myocyte triglyceride levels relate negatively to insulin sensitivity, but their interrelationships are inadequately characterized in the overweight. Using recent methods for measuring intramyocyte triglyceride, these relationships were studied in men with a broad range of adiposity.


METHODS
Myocyte triglyceride content ((1)H-magnetic resonance spectroscopy of soleus and tibialis anterior muscles and biochemical assessment of vastus lateralis biopsies), regional fat distribution (DXA and abdominal magnetic resonance imaging), serum lipids, insulin action (euglycemic hyperinsulinemic clamp), and substrate oxidation rates (indirect calorimetry) were measured in 39 nondiabetic men (35.1 +/- 7.8 years) with a broad range of adiposity (BMI 28.6 +/- 4.1 kg/m(2), range 20.1 to 37.6 kg/m(2)).


RESULTS
Relationships between insulin-stimulated glucose disposal and regional body fat depots appeared more appropriately described by nonlinear than linear models. When the group was subdivided using median total body fat as the cut-point, insulin-stimulated glucose disposal correlated negatively to all regional body fat measures (all p < or = 0.004), serum triglycerides and free fatty acids (p < 0.02), and both soleus intramyocellular lipid (p = 0.003) and vastus lateralis triglyceride (p = 0.04) in the normal/less overweight group. In contrast, only visceral abdominal fat showed significant negative correlation with insulin-stimulated glucose disposal in more overweight men (r = -0.576, p = 0.01), some of whom surprisingly had lower than expected myocyte lipid levels. These findings persisted when the group was subdivided using different cut-points or measures of adiposity.


CONCLUSIONS
Interrelationships among body fat depots, myocyte triglyceride, serum lipids, and insulin action are generally absent with increased adiposity. However, visceral abdominal fat, which corresponds less closely to total adiposity, remains an important predictor of insulin resistance in men with both normal and increased adiposity.
Gan
Seng Khee
SK
Metabolism and Diabetes Research Program, Garvan Institute of Medical Research, 384 Victoria Street, Darlinghurst, Sydney, NSW 2010, Australia.
Kriketos
Adamandia D
AD
Poynten
Ann M
AM
Furler
Stuart M
SM
Thompson
Campbell H
CH
Kraegen
Edward W
EW
Campbell
Lesley V
LV
Chisholm
Donald J
DJ
D000005:Abdomen; D000273:Adipose Tissue; D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D007333:Insulin Resistance; D008055:Lipids / Q000032:analysis* / Q000097:blood; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D032342:Muscle Cells / Q000737:chemistry*; D018482:Muscle, Skeletal / Q000737:chemistry; D014280:Triglycerides / Q000032:analysis
D007328:Insulin; D008055:Lipids; D014280:Triglycerides