Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study.
Diabetologia 2009;52:2079-86
Hanley AJ, Wagenknecht LE, Norris JM, Bryer-Ash M, Chen YI, Anderson AM, Bergman R, Haffner SM
This study examines the associations between intra-abdominal or visceral (VAT) and subcutaneous (SAT) adipose tissue, insulin sensitivity and acute insulin response with the incidence of type 2 diabetes. A total of 1 230 Hispanic-Americans and African-Americans of the Insulin Resistance Atherosclerosis Study (IRAS) were followed for 5 years and incident type 2 diabetes was diagnosed in 90 participants. After adjustment for age, sex, ethnicity, centre, impaired fasting glucose, triacylglycerol, HDL cholesterol and systolic blood pressure, results demonstrated a substantial and significantly reduced risk of incident type 2 diabetes among participants with higher levels of insulin sensitivity and secretion. Although, increased VAT and SAT were positively correlated with type 2 diabetes, VAT continued to predict diabetes after adjustment for SAT. Thus, insulin resistance, beta cell dysfunction and VAT predicted development of type 2 diabetes with evidence of a stronger association of VAT with type 2 diabetes among women. Ethnicity did not modify the association of VAT with incident type 2 diabetes.