title: Interscapular fat is strongly associated with insulin resistance.
abstract: BACKGROUND
  Subcutaneous abdominal adipose tissue (SCAAT), visceral adipose tissue (VAT), fat in the neck area [interscapular fat (IF)], and liver fat (LF) are associated with metabolic traits related to insulin resistance. Whole-body magnetic resonance imaging and spectroscopy offer a unique approach to quantify fat depots in larger cohorts.
  
  
  OBJECTIVE
  The objective was to study 1) the impact of the aforementioned fat depots on insulin sensitivity in a cross-sectional design and 2) changes in these fat depots and in insulin sensitivity during a lifestyle intervention (LI).
  
  
  METHODS
  One hundred eighty-seven subjects were included in the cross-sectional study. Follow-up data during LI were available in 172 subjects. Body fat depots were quantified by whole-body magnetic resonance imaging, and representative reference slices at the umbilical level (SCAAT, VAT) and at the level of the shoulder joint (IF) were analyzed. LF was measured by (1)H-magnetic resonance spectroscopy. Insulin sensitivity was estimated from an oral glucose tolerance test.
  
  
  RESULTS
  Cross-sectionally, SCAAT, VAT, IF, and LF were negatively associated with IS (all P < 0.0001). The change in insulin sensitivity during LI was associated with the changes in these fat depots (all P < 0.001). In a multivariate model, the change in insulin sensitivity during LI adjusted for gender, age, LF, and IF at baseline was associated with change in IF (P < 0.01) and with change in LF (P < 0.0001).
  
  
  CONCLUSIONS
  IF represents a subcutaneous fat depot determining whole-body IS, both cross-sectionally and during LI. The impact of LF and IF on insulin sensitivity appears to be independent from each other. Additional studies are needed to clarify the metabolic properties of IF.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology, and Clinical Chemistry, Eberhard Karls University, Tübingen, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Thamer
authors.forename: Jürgen
authors.initials: J
authors.lastname: Machann
authors.forename: Harald
authors.initials: H
authors.lastname: Staiger
authors.forename: Karsten
authors.initials: K
authors.lastname: Müssig
authors.forename: Nina
authors.initials: N
authors.lastname: Schwenzer
authors.forename: Burkhard
authors.initials: B
authors.lastname: Ludescher
authors.forename: Fausto
authors.initials: F
authors.lastname: Machicao
authors.forename: Claus
authors.initials: C
authors.lastname: Claussen
authors.forename: Andreas
authors.initials: A
authors.lastname: Fritsche
authors.forename: Fritz
authors.initials: F
authors.lastname: Schick
authors.forename: Norbert
authors.initials: N
authors.lastname: Stefan
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Häring
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004035:Diet Therapy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000502:physiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D011859:Radiography; D040242:Risk Reduction Behavior; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000502:physiology; D055815:Young Adult