Relation of abdominal fat depots to systemic markers of inflammation in type 2 diabetes.
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.
Sam
Susan
S
Department of Medicine, Section of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, Chicago, Illinois, USA.
Haffner
Steven
S
Davidson
Michael H
MH
D'Agostino
Ralph B
RB
Feinstein
Steven
S
Kondos
George
G
Perez
Alfonso
A
Mazzone
Theodore
T
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
D015415:Biomarkers; D007004:Hypoglycemic Agents; D002097:C-Reactive Protein