title: Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes.
abstract: OBJECTIVE
  Unlike visceral adipose tissue (VAT), the association between subcutaneous adipose tissue (SAT) and obesity-related morbidity is controversial. In patients with type 2 diabetes, we assessed whether this variability can be explained by a putative favorable, distinct association between abdominal superficial SAT (SSAT) (absolute amount or its proportion) and cardiometabolic parameters.
  
  
  METHODS
  We performed abdominal magnetic resonance imaging (MRI) in 73 patients with diabetes (mean age 58 years, 83% were men) and cross-sectionally analyzed fat distribution at S1-L5, L5-L4, and L3-L2 levels. Patients completed food frequency questionnaires, and subgroups had 24-h ambulatory blood pressure monitoring and 24-h ambulatory electrocardiography.
  
  
  RESULTS
  Women had higher %SSAT (37 vs. 23% in men; P < 0.001) despite a similar mean waist circumference. Fasting plasma glucose (P = 0.046) and HbA(1c) (P = 0.006) were both lower with increased tertile of absolute SSAT. In regression models adjusted for age, waist circumference, and classes of medical treatments used in this patient population, increased %SSAT was significantly associated with decreased HbA(1c) (β = -0.317; P = 0.013), decreased daytime ambulatory blood pressure (β = -0.426; P = 0.008), and increased HDL cholesterol (β = 0.257; P = 0.042). In contrast, increased percent of deep SAT (DSAT) was associated with increased HbA(1c) (β = 0.266; P = 0.040) and poorer heart rate variability parameters (P = 0.030). Although total fat and energy intake were not correlated with fat tissue distribution, increased intake of trans fat tended to be associated with total SAT (r = 0.228; P = 0.05) and DSAT (r = 0.20; P = 0.093), but not with SSAT.
  
  
  CONCLUSIONS
  Abdominal SAT is composed of two subdepots that associate differently with cardiometabolic parameters. Higher absolute and relative distribution of fat in abdominal SSAT may signify beneficial cardiometabolic effects in patients with type 2 diabetes.
authors.affiliation: The S. Daniel Abraham International Center for Health and Nutrition, Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Rachel
authors.initials: R
authors.lastname: Golan
authors.forename: Ilan
authors.initials: I
authors.lastname: Shelef
authors.forename: Assaf
authors.initials: A
authors.lastname: Rudich
authors.forename: Yftach
authors.initials: Y
authors.lastname: Gepner
authors.forename: Elad
authors.initials: E
authors.lastname: Shemesh
authors.forename: Yoash
authors.initials: Y
authors.lastname: Chassidim
authors.forename: Ilana
authors.initials: I
authors.lastname: Harman-Boehm
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Henkin
authors.forename: Dan
authors.initials: D
authors.lastname: Schwarzfuchs
authors.forename: Sivan
authors.initials: S
authors.lastname: Ben Avraham
authors.forename: Shula
authors.initials: S
authors.lastname: Witkow
authors.forename: Idit F
authors.initials: IF
authors.lastname: Liberty
authors.forename: Osnat
authors.initials: O
authors.lastname: Tangi-Rosental
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sarusi
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: Iris
authors.initials: I
authors.lastname: Shai
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D050507:Subcutaneous Fat, Abdominal / Q000378:metabolism*
chemical_list: D001786:Blood Glucose