You are here

Article Text

Article menu

Download PDFPDF

XML
Epidemiology/Health Services Research
Relationship of obesity to adipose tissue insulin resistance
  1. Jiajia Jiang1,2,
  2. Xueli Cai3,
  3. Yuesong Pan4,5,
  4. Xiaoyan Du6,
  5. Huiping Zhu1,
  6. Xinghua Yang1,
  7. Deqiang Zheng1,
  8. Herbert Gaisano7,
  9. Tiemin Wei3,
  10. Yan He1,8
  1. 1Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China
  2. 2Department of Endocrinology, Jining No. 1 People’s Hospital, Jining, Shandong, China
  3. 3Department of Neurology, Lishui Central Hospital and Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, Zhejiang, China
  4. 4Department of Neurology, Beijing Tiantan Hospital, Beijing, China
  5. 5Department of Statistics, China National Clinical Research Center for Neurological Diseases, Beijing, China
  6. 6Department of Laboratory Animal, School of Basic Medical Sciences, Capital Medical University, Beijing, China
  7. 7Departments of Medicine and Physiology, University of Toronto, Toronto, Ontario, Canada
  8. 8Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
  1. Correspondence to Dr Yan He; yanhe1220{at}126.com; Dr Yuesong Pan; yuesongpan{at}ncrcnd.org.cn

Abstract

Aims This study aimed to examine the association of different anatomical forms of obesity with adipose tissue insulin resistance and to assess the diagnostic value and contribution of obesity to adipose tissue insulin resistance.

Methods This cross-sectional study included a total of 499 subjects aged 50 years or over. Multivariate regression analysis was conducted to clarify the association of different forms of obesity with adipose tissue insulin resistance (calculated as fasting insulin level×fasting free fatty acids level). Receiver operating characteristic cure analyses were used to assess the diagnostic value of each anthropometric indicator for adipose tissue insulin resistance. Attributable risk per cent and population attributable risk per cent were calculated to assess the contribution of obesity to adipose tissue insulin resistance.

Results After adjustment for potential confounders, we showed that anthropometric indicators were all positively associated with adipose tissue insulin resistance. In males, waist circumference (WC) was the strongest associated factor (OR, 3.43 (95% CI 2.03 to 5.82)) and indicator (area under the curve (AUC): 0.79) of adipose tissue insulin resistance among those indicators. Here, abdominal obesity (WC≥90 cm) accounted for 64.9% of adipose tissue insulin resistance in the abdominal obese males. Accordingly, body mass index (BMI) was the strongest associated factor (OR,3.08 (95% CI 2.04 to 4.66)) and indicator (AUC: 0.78) of adipose tissue insulin resistance in females. Here, general obesity of BMI≥25 kg/m2 accounted for 66.2% of the adipose tissue insulin resistance in the general obese females. We further demonstrated that adipose tissue insulin resistance was associated or trended to be associated with the metabolic diseases of cardiovascular disease, type 2 diabetes and fatty liver in subjects with normal BMI and WC.

Conclusions Maintaining WC in males and BMI in females to a normal range could be an important strategy to significantly reduce the occurrence of adipose tissue insulin resistance and the subsequent metabolic diseases.

  • obesity
  • insulin resistance
  • BMI
  • waist circumference
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000741

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • JJ and XC contributed equally.

    • Contributors Each author has been involved in and contributed to this manuscript. Conceptualization: DZ and TW. Data curation: JJ and YP. Formal analysis: JJ and XC. Investigation: YP and XY. Methodology: HZ and XY. Project administration: TW and YH. Software: DZ. Supervision: XD and HZ. Validation: XD. Visualization: XC. Writing—original draft: JJ and XC. Writing—review and editing: HG and YH. All authors approved final version of the manuscript to be published.

    • Funding This study was supported by National Natural Science Foundation of China (31672375) to YH, Ministry of Science and Technology of the People’s Republic of China (2017YFC1310902,2018YFC1311700 and 2018YFC1311706), National Natural Science Foundation of China (81971091) and Beijing Hospitals Authority Youth Programme (QML20190501) to YP, Lishui Science &Technology Bureau(2019ZDYF18)

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval All subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Committee on Human Research of the Lishui Central Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available. Because follow-up study of this investigation is still in progress, data sharing cannot be carried out for now.