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Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO grade III obesity

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Summary Objective 

Although associations between visceral adiposity (intra-abdominal fat mass) and insulin resistance are well established, previous data include few subjects with WHO grade III obesity [body mass index (BMI) > 40 kg/m2]. We have investigated the relationship between visceral adiposity and insulin resistance using computed tomography (CT)-quantified fat mass and the homeostasis model assessment for insulin resistance (HOMA-IR) in patients with severe obesity. Patients and methods 

Eighteen nondiabetic subjects with BMI > 40 kg/m2 were recruited. BMI, and waist, hip and neck circumferences were measured. Fasting plasma insulin and glucose were measured to calculate HOMA-IR. A single slice CT scan was taken at L4 and visceral and abdominal subcutaneous adipose tissue (VAT and ASAT, respectively) quantified using ‘SliceOmatic’ image analysis software. Results 

A close correlation was demonstrated between VAT and HOMA-IR (r2 = 0·46, P = 0·002), whereas ASAT showed no relationship. Neck circumference correlated with both VAT (r2 = 0·67, P < 0·0001) and HOMA-IR (r2 = 0·35, P = 0·01). Waist circumference only correlated significantly with VAT (r2 = 0·25, P = 0·03). Conclusions 

Visceral adiposity remains a strongly significant indicator of insulin resistance in WHO grade III obesity. Neck circumference surpasses other anthropometric measurements as a powerful marker of both VAT and insulin resistance.
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Document Type: Research Article

Affiliations: 1: Endocrinology Department, King’s College Hospital, Denmark Hill, London 2: King’s College London School of Medicine Diabetes Research Group, Denmark Hill, London 3: Radiology Department, King’s College Hospital, Denmark Hill, London, UK

Publication date: August 1, 2010

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