Document Detail


Insulin-sensitive obesity.
MedLine Citation:
PMID:  20570822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The association between obesity and impaired insulin sensitivity has long been recognized, although a subgroup of obese individuals seems to be protected from insulin resistance. In this study, we systematically studied differences in adipose tissue biology between insulin-sensitive (IS) and insulin-resistant (IR) individuals with morbid obesity. On the basis of glucose infusion rate during euglycemic hyperinsulinemic clamps, 60 individuals with a BMI of 45 +/- 1.3 kg/m(2) were divided into an IS and IR group matched for age, sex, and body fat prior to elective surgery. We measured fat distribution, circulating adipokines, and parameters of inflammation, glucose, and lipid metabolism and characterized adipose tissue morphology, function, and mRNA expression in abdominal subcutaneous (sc) and omental fat. IS compared with IR obese individuals have significantly lower visceral fat area (138 +/- 27 vs. 316 +/- 91 cm(2)), number of macrophages in omental adipose tissue (4.9 +/- 0.8 vs. 13.2 +/- 1.4%), mean omental adipocyte size (528 +/- 76 vs. 715 +/- 81 pl), circulating C-reactive protein, progranulin, chemerin, and retinol-binding protein-4 (all P values <0.05), and higher serum adiponectin (6.9 +/- 3.4 vs. 3.4 +/- 1.7 ng/ml) and omental adipocyte insulin sensitivity (all P values <0.01). The strongest predictors of insulin sensitivity by far were macrophage infiltration together with circulating adiponectin (r(2) = 0.98, P < 0.0001). In conclusion, independently of total body fat mass, increased visceral fat accumulation and adipose tissue dysfunction are associated with IR obesity. This suggests that mechanisms beyond a positive caloric balance such as inflammation and adipokine release determine the pathological metabolic consequences in patients with obesity.
Authors:
Nora Klöting; Mathias Fasshauer; Arne Dietrich; Peter Kovacs; Michael R Schön; Matthias Kern; Michael Stumvoll; Matthias Blüher
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-22
Journal Detail:
Title:  American journal of physiology. Endocrinology and metabolism     Volume:  299     ISSN:  1522-1555     ISO Abbreviation:  Am. J. Physiol. Endocrinol. Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-26     Completed Date:  2010-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901226     Medline TA:  Am J Physiol Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E506-15     Citation Subset:  IM    
Affiliation:
Department of Medicine, Interdisciplinary Centre for Clinical Research, University of Leipzig, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adipocytes / cytology,  metabolism
Adipokines / blood,  genetics
Adult
Blood Glucose / metabolism
Body Composition / physiology
C-Reactive Protein / metabolism
Chemokines / blood,  genetics
Female
Glucose Clamp Technique
Humans
Insulin Resistance / physiology*
Intercellular Signaling Peptides and Proteins / blood,  genetics
Intra-Abdominal Fat / cytology,  metabolism*
Male
Middle Aged
Obesity, Morbid / metabolism*
RNA, Messenger / genetics,  metabolism
Retinol-Binding Proteins, Plasma / genetics,  metabolism
Reverse Transcriptase Polymerase Chain Reaction
Subcutaneous Fat / cytology,  metabolism*
Chemical
Reg. No./Substance:
0/Adipokines; 0/Blood Glucose; 0/Chemokines; 0/GRN protein, human; 0/Intercellular Signaling Peptides and Proteins; 0/RBP4 protein, human; 0/RNA, Messenger; 0/Retinol-Binding Proteins, Plasma; 0/chemerin, human; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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