Vol 5, No 5 (2004): Practical Diabetology
Other materials agreed with the Editors
Published online: 2004-10-26
Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome
Diabetologia Praktyczna 2004;5(5):283-292.
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.
Keywords: metabolic syndromecentral adiposityinsulin sensitivityintra-abdominal fat