Vol 5, No 5 (2004): Practical Diabetology
Original articles (translated)
Published online: 2004-10-26
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Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome

Darcy B. Carr, Kristina M. Utzschneider, Rebecca L. Hull, Keiichi Kodama, Barbara M. Retzlaff, John D. Brunzell, Jane B. Shofer, Brian E. Fish, Robert H. Knopp, Steven E. Kahn
Diabetologia Praktyczna 2004;5(5):283-292.
Vol 5, No 5 (2004): Practical Diabetology
Original articles (translated)
Published online: 2004-10-26

Abstract

The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26–75 years) and BMI (18.4–46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 × × 10–5 min–1/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose < 6.4 mmol/l.

Abstract

The underlying pathophysiology of the metabolic syndrome is the subject of debate, with both insulin resistance and obesity considered as important factors. We evaluated the differential effects of insulin resistance and central body fat distribution in determining the metabolic syndrome as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III. In addition, we determined which NCEP criteria were associated with insulin resistance and central adiposity. The subjects, 218 healthy men (n = 89) and women (n = 129) with a broad range of age (26–75 years) and BMI (18.4–46.8 kg/m2), underwent quantification of the insulin sensitivity index (Si) and intra-abdominal fat (IAF) and subcutaneous fat (SCF) areas. The metabolic syndrome was present in 34 (15.6%) of subjects who had a lower Si [median: 3.13 vs. 6.09 × × 10–5 min–1/(pmol/l)] and higher IAF (166.3 vs. 79.1 cm2) and SCF (285.1 vs. 179.8 cm2) areas compared with subjects without the syndrome (P < 0.001). Multivariate models including Si, IAF, and SCF demonstrated that each parameter was associated with the syndrome. However, IAF was independently associated with all five of the metabolic syndrome criteria. In multivariable models containing the criteria as covariates, waist circumference and triglyceride levels were independently associated with Si and IAF and SCF areas (P < 0.001). Although insulin resistance and central body fat are both associated with the metabolic syndrome, IAF is independently associated with all of the criteria, suggesting that it may have a pathophysiological role. Of the NCEP criteria, waist circumference and triglycerides may best identify insulin resistance and visceral adiposity in individuals with a fasting plasma glucose < 6.4 mmol/l.
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Keywords

metabolic syndrome; central adiposity; insulin sensitivity; intra-abdominal fat

About this article
Title

Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome

Journal

Clinical Diabetology

Issue

Vol 5, No 5 (2004): Practical Diabetology

Pages

283-292

Published online

2004-10-26

Bibliographic record

Diabetologia Praktyczna 2004;5(5):283-292.

Keywords

metabolic syndrome
central adiposity
insulin sensitivity
intra-abdominal fat

Authors

Darcy B. Carr
Kristina M. Utzschneider
Rebecca L. Hull
Keiichi Kodama
Barbara M. Retzlaff
John D. Brunzell
Jane B. Shofer
Brian E. Fish
Robert H. Knopp
Steven E. Kahn

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