The visceral and subcutaneous fat changes in type 1 diabetes: a pilot study.
OBJECTIVE
To evaluate the effects of improved glycaemic control on the abdominal visceral and subcutaneous fat in type 1 diabetes.


METHODS
Sixteen subjects were enrolled for this 6-month study. The goal was to achieve normal haemoglobin A1c (HbA1c <5.6% in our laboratory). T1-weighted magnetic resonance imaging was used to measure the abdominal subcutaneous and visceral fat areas at the L2-L3 disk level. Activity and energy intake were assessed using a weekly recall and food diary respectively. Plasma leptin, ghrelin and adiponectin levels were measured at baseline and at 6 months.


RESULTS
Twelve subjects completed the study. HbA1c was 10.4 +/- 2.2% at baseline, and abdominal visceral to subcutaneous fat ratio was 0.29 +/- 0.15. HbA1c dropped to 8.0 +/- 1.4% at 6 months (p = 0.009). There was a +1.85 kg weight change in 6 months (p = 0.30), whereas the visceral to subcutaneous fat ratios changed to 0.36 +/- 0.18 (p = 0.22). Daily metabolic equivalents (METs) of activity at 6 months correlated with a decrease in the visceral to subcutaneous fat ratios (r = -0.80, p = 0.01). Ghrelin level changes correlated negatively with the changes in the visceral to subcutaneous fat ratio (p < 0.01).


CONCLUSIONS
The visceral to subcutaneous fat changes had a negative correlation with the physical activity METs at 6 months but not with HbA1c changes in this study. The correlation between the changes in ghrelin and the visceral to subcutaneous fat ratios is intriguing, but a larger study may be needed to confirm this finding.
Jacob
A N
AN
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390-8858, USA.
Adams-Huet
B
B
Raskin
P
P
D052242:Adiponectin / Q000097:blood; D000328:Adult; D001823:Body Composition; D008076:Cholesterol, HDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D004435:Eating; D005260:Female; D054439:Ghrelin; D006442:Glycated Hemoglobin; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D050152:Intra-Abdominal Fat / Q000473:pathology*; D020738:Leptin / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D036361:Peptide Hormones / Q000097:blood; D005082:Physical Exertion; D010865:Pilot Projects; D011446:Prospective Studies; D050151:Subcutaneous Fat / Q000473:pathology*; D015430:Weight Gain / Q000187:drug effects
D052242:Adiponectin; D008076:Cholesterol, HDL; D054439:Ghrelin; D006442:Glycated Hemoglobin; D006454:Hemoglobins; D007004:Hypoglycemic Agents; D007328:Insulin; D020738:Leptin; D036361:Peptide Hormones; C517652:hemoglobin A1c protein, human