Die Beziehung zwischen Körperfettverteilung, Insulinspiegeln und Glukosetoleranz bei übergewichtigen Frauen

Summary

Relationship between body fat distribution, serum insulin, and glucose tolerance in obese, non-diabetic women. Recent studies suggest that hyperinsulinemia and upper body obesity are predictive factors for the development of non-insulindependent diabetes mellitus. To further characterize the relationship between body fat distribution, serum insulin, and glucose tolerance an oral glucose tolerance test was performed in 48 obese, nondiabetic women. Fasting insulin levels were correlated to both total body fat calculated as body mass index (r=0.58,p<0.001) and upper body fat distribution expressed as waist-to-hip ratio (WHR,r=0.47,p<0.01). In the women with upper body fat localization (WHR>0.90) significantly higher basal and glucose-stimulated insulin concentrations were established than in the women with a lower body type of obesity (WHR<0.78) (basal insulin 27.4±11.5 vs. 15.4±8.8 mU/l,p<0.05, insulin area 779±320 vs. 468±237 U,p<0.05). They also had impaired glucose tolerance (glucose area 925±139 vs. 633±147 U,p<0.01). Fasting triglyceride concentrations were correlated both with WHR (r=0.63,p<0.001) and fasting insulin (r=0.33,p<0.05) but not with BMI (r=−0.02, n.s.). A positive association was found between systolic and diastolic blood pressure and both WHR (r=0.43 andr=0.44 resp.,p<0.01) and BMI (eachr=0.35,p<0.05). Interestingly, basal insulin was also associated with blood pressure (r=0.30,p<0.1, andr=0.40,p<0.01 resp.). These results suggest a close relationship between upper body obesity, hyperinsulinemia, and impaired glucose tolerance. Women with an upper body tpye of obesity also show tendencies to hypertriglyceridemia and hypertension. Obese women with upper body obesity represent a subgroup of the obesity population with an increased risk to develop type-II diabetes.