This paper sought to determine whether greater intra-abdominal (visceral) adiposity directly measured by computed tomography was associated with a future increase in insulin resistance [assessed by multiple measures, including homeostasis model assessment for insulin resistance (HOMA-IR), fasting plasma insulin, Matsuda index, and insulin area under the oral glucose tolerance test curve (AUC)] independent of other adipose depots. For the current analysis, 306 nondiabetic Japanese American subjects were followed over 10-11 years. The prospective data showed that both baseline intra-abdominal fat area and HOMA-IR were independently associated with increased HOMA-IR at 10-11 years in a multivariate model that included subcutaneous adipose tissue. Moreover, abdominal subcutaneous fat area and total subcutaneous fat area were not independently associated with future fasting plasma insulin levels, HOMA-IR, Matsuda index, and insulin AUC in multiple-adjusted models, which suggests that among all fat depots, intra-abdominal fat plays the most important role in predicting future insulin resistance. The authors concluded that reducing intra-abdominal fat may help prevent future elevations of fasting plasma insulin levels, HOMA-IR, Matsuda index, and insulin AUC.
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