The aim of this study was to investigate the association between abdominal subcutaneous adipose tissue, intra-abdominal (visceral) adipose tissue and various measures of insulin sensitivity. For that purpose, participants without diabetes from the Framingham Heart Study, who underwent multidetector computed tomography to assess subcutaneous adipose tissue and intra-abdominal adipose tissue (n=3,093; 48% women; mean age=50.4 years; mean body mass index=27.6 kg/m2), were evaluated. The authors included four different insulin measures in the analysis such as insulin levels and HOMA-IR which are measures of insulin resistance and proinsulin and proinsulin/insulin ratio which are measures of pancreatic β-cell secretory function. Analyses revealed that both subcutaneous adipose tissue and intra-abdominal adipose tissue were significantly associated with insulin, proinsulin, proinsulin/insulin ratio and HOMA-IR. However, intra-abdominal adipose tissue was a stronger correlate of insulin variables than subcutaneous adipose tissue. Moreover, results showed an interaction between adipose tissue depots and age-group. More specifically, there was a stronger association between subcutaneous adipose tissue and insulin and HOMA-IR among older individuals (≥50 years). In addition, there was a stronger association between intra-abdominal adipose tissue and proinsulin and proinsulin/insulin ratio among the younger participants (<50 years of age). It was also found that there was a stronger association between intra-abdominal adipose tissue and insulin, proinsulin, and HOMA-IR among obese participants as compared to normal-weight participants. Finally, individuals with high subcutaneous adipose tissue and high intra-abdominal adipose tissue had greater insulin and proinsulin levels than those with elevated levels of either depot alone. These results support the strong link between intra-abdominal adipose tissue and insulin resistance.
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