title: Relation of abdominal fat depots to systemic markers of inflammation in type 2 diabetes.
abstract: OBJECTIVE
  Both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) have been linked to systemic inflammation in nondiabetic cohorts. We examined the relationships between VAT and SAT and systemic inflammatory markers in a large well-characterized cohort of subjects with type 2 diabetes.
  
  
  METHODS
  Three hundred eighty-two subjects with type 2 diabetes in the CHICAGO (Carotid Intima-Media Thickness in Atherosclerosis Using Pioglitazone) study 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 A1C.
  
  
  RESULTS
  VAT was positively related to CRP, monocyte chemoattractant protein (MCP), intracellular adhesion molecule (ICAM)-1, and plasminogen activator inhibitor type 1 (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 vascular cell adhesion molecule (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 IL-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.
authors.affiliation: Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Sam
authors.forename: Steven
authors.initials: S
authors.lastname: Haffner
authors.forename: Michael H
authors.initials: MH
authors.lastname: Davidson
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Steven
authors.initials: S
authors.lastname: Feinstein
authors.forename: George
authors.initials: G
authors.lastname: Kondos
authors.forename: Alfonso
authors.initials: A
authors.lastname: Perez
authors.forename: Theodore
authors.initials: T
authors.lastname: Mazzone
mesh_terms: D000005:Abdomen / Q000033:anatomy & histology*; D000273:Adipose Tissue / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D044383:Black People; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002641:Chicago; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012727:Sex Characteristics; D014057:Tomography, X-Ray Computed; D049629:Waist-Hip Ratio; D044465:White People; D001741:Black or African American
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D002097:C-Reactive Protein