In this cross-sectional study, Kotronen et al. measured hepatic and muscle fat content as well as insulin sensitivity using the euglycemic-hyperinsulinemic clamp technique in a sample of 45 middle-aged men. The goal was to investigate the relationship between ectopic fat accumulation, insulin resistance, and the metabolic syndrome. Participants with the metabolic syndrome had a fivefold increase in liver fat content compared to subjects without the metabolic syndrome. Intramyocellular fat did not differ between the two groups. Hyperinsulinemia and plasma adiponectin levels were also worse in participants with liver fat but not in those with increased intramyocellular fat. Both ectopic fat depots were linked to intra-abdominal (visceral) fat accumulation and insulin sensitivity. These results concur with the authors’ previous work showing that insulin fails to decrease VLDL production in subjects with the atherogenic dyslipidemia of the metabolic syndrome. Further research on ectopic fat deposition is clearly warranted, particularly on the relationship of liver fat to global cardiometabolic risk.
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