Fat redistribution and accumulation of visceral adipose tissue predicts type 2 diabetes risk in middle-aged black South African women: a 13-year longitudinal study.,Nutrition & Diabetes

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Fat redistribution and accumulation of visceral adipose tissue predicts type 2 diabetes risk in middle-aged black South African women: a 13-year longitudinal study.
Nutrition & Diabetes ( IF 4.6 ) Pub Date : 2019-03-27 , DOI: 10.1038/s41387-019-0079-8
Asanda Mtintsilana ₁ , Lisa K Micklesfield ₁ , Elin Chorell ₂ , Tommy Olsson ₂ , Julia H Goedecke _{1,

3}

Affiliation

BACKGROUND Cross-sectional studies in South Africa (SA) have shown that black SA women, despite being more insulin resistant, have less visceral adipose tissue (VAT) and more subcutaneous adipose tissue (SAT) than white women. This study aimed to investigate whether baseline and/or change in body fat and its distribution predict type 2 diabetes (T2D) risk in middle-aged black SA women, 13 years later. METHODS We studied 142 black SA women who are the caregivers of the Birth-to-Twenty plus cohort, and who had normal glucose tolerance (NGT) at baseline. At baseline and follow-up, fasting blood samples, basic anthropometry and dual-energy X-ray absorptiometry-derived body composition were measured. At follow-up, an oral glucose tolerance test was completed. The WHO diabetes diagnostic criteria were used to define NGT, impaired fasting glucose (IFG)/impaired glucose tolerance (IGT), impaired glucose metabolism (IGM) and T2D. RESULTS At follow-up, 64% of participants remained NGT, whereas 25% developed IGM, and 11% developed T2D. The IGM and the T2D groups were combined for statistical analyses. At baseline, trunk fat mass (FM), VAT but not SAT (measures of central FM) were higher in the IGM/T2D group than the NGT group (p < 0.0001). In contrast, the IGM/T2D group had lower leg %FM at baseline than the NGT group (p < 0.0001). Baseline trunk FM (Odds ratio per 1 kg increase (95% confidence interval, 1.95 (1.43-2.67))), and VAT (OR per 10 cm2 increase, 1.25 (1.10-1.42)), and the change in VAT (1.12 (1.03-1.23)) were associated with greater odds of developing IGM/T2D, whereas baseline leg FM (OR per 1 kg increase, 0.55 (0.41-0.73)) were associated with reduced IGM/T2D risk at follow-up (p < 0.05). CONCLUSIONS Relative fat redistribution, with VAT accumulation, predicted the development of IGM/T2D 13 years before its onset. Prevention of central obesity is a key factor to reduce the risk of developing T2D among middle-aged urban black SA women.

中文翻译：

脂肪再分配和内脏脂肪组织的累积预测南非中年黑人女性患有2型糖尿病的风险：一项为期13年的纵向研究。

背景技术南非（SA）的横断面研究表明，黑人SA妇女尽管对胰岛素的抵抗力更高，但与白人妇女相比，内脏脂肪组织（VAT）少，皮下脂肪组织（SAT）多。这项研究旨在调查13年后的中年黑人SA女性中，基线脂肪和/或脂肪的变化及其分布是否可以预测2型糖尿病（T2D）风险。方法我们研究了142名黑人SA妇女，她们是20岁以上出生队列的照料者，并且基线时的葡萄糖耐量（NGT）正常。在基线和随访时，测量了空腹血样，基本人体测量学和双能X线骨密度仪得出的身体成分。随访时，完成了口服葡萄糖耐量测试。WHO的糖尿病诊断标准用于定义NGT，空腹血糖（IFG）受损/葡萄糖耐量（IGT）受损，葡萄糖代谢（IGM）和T2D受损。结果随访时，仍有64％的受试者保留NGT，而25％的受试者发展了IGM，11％的受试者发展了T2D。将IGM和T2D组合并进行统计分析。基线时，IGM / T2D组的躯干脂肪质量（FM），VAT而非SAT（中央FM的测量值）高于NGT组（p <0.0001）。相反，IGM / T2D组在基线时的腿部％FM低于NGT组（p <0.0001）。基线干线FM（每1公斤增加的赔率（95％置信区间，1.95（1.43-2.67）））和增值税（每10平方厘米增加的赔率，1.25（1.10-1.42）），以及增值税的变化（1.12（ 1.03-1.23））与发生IGM / T2D的几率更高相关，而基线腿部FM（每增加1千克增加OR，0.55（0.41-0。73））与随访时IGM / T2D风险降低相关（p <0.05）。结论相对脂肪的重新分布，加上增值税的积累，预示了IGM / T2D发病前13年的发展。预防中枢性肥胖是降低中年城市黑人SA妇女患T2D风险的关键因素。

更新日期：2019-03-27

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