Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance.

ABSTRACT

OBJECTIVES: To examine the specific distribution of liver fat content, visceral and subcutaneous adiposity in normal glucose tolerance (NGT/NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined conditions (IFG+IGT), as well as with newly diagnosed type 2 diabetes (nT2D). DESIGN: Multicenter, international observational study cross-sectional analysis. SUBJECTS: Two thousand five hundred and fifteen patients (50.0% women, 54.5% non-Caucasian) without previously known diabetes were recruited from 29 countries. Abdominal fat distribution was measured by computed tomography (CT). Liver fat was estimated using the CT-liver mean attenuation. RESULTS: Compared with NGT/NGT patients, increased visceral adiposity was found in iIFG, iIGT, IFG+IGT and nT2D; estimated liver fat progressively increased across these conditions. A one-s.d. increase in visceral adiposity was associated with an increased risk of having iIFG (men odds ratio (OR) 1.41 (95% confidence interval (CI) 1.15-1.74), women OR 1.62 (1.29-2.04)), iIGT (men OR 1.59 (1.15-2.01), women OR 1.30 (0.96-1.76)), IFG+IGT (men OR 1.64 (1.27-2.13), women OR 1.83 (1.36-2.48)) and nT2D (men OR 1.80 (1.35-2.42), women OR 1.73 (1.25-2.41)). A one-s.d. increase in estimated liver fat was associated with iIGT (men OR 1.46 (1.12-1.90), women OR 1.81 (1.41-2.35)), IFG+IGT (men OR 1.42 (1.14-1.77), women OR 1.74 (1.35-2.26)) and nT2D (men OR 1.77 (1.40-2.27), women OR 2.38 (1.81-3.18)). Subcutaneous abdominal adipose tissue showed an inverse relationship with nT2D in women (OR 0.63 (0.45-0.88)). CONCLUSIONS: Liver fat was associated with iIGT but not with iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D, whereas subcutaneous adiposity showed an inverse relationship with nT2D in women.