Unique Effect of Visceral Fat on Insulin Sensitivity in Obese Hispanic Children With a Family History of Type 2 Diabetes

Abstract

OBJECTIVE—This study aimed to establish whether total fat or central fat was related to measures of insulin in obese Hispanic children with a family history of type 2 diabetes. RESEARCH DESIGN AND METHODS—Subjects were 32 children aged 8–13 years. Visceral fat and subcutaneous abdominal fat were determined by magnetic resonance imaging at the umbilicus and total body fat was determined by dual-energy X-ray absorptiometry. Insulin sensitivity (Si) and acute insulin response (AIR) were determined by frequently sampled intravenous tolerance test with minimal modeling. RESULTS—Mean fasting glucose and insulin, Si, and AIR (± SD) were 5.3 ± 0.3 mmol/l, 206 ± 105 pmol/l, 11.8 ± 5.7 [× 10−4 min−1/(pmol/l)], and 17,175 ± 9,695 (pmol/l × 10 min), respectively. In multivariate regression analysis, total fat mass was independently and positively related to fasting insulin (P < 0.01) and negatively related to Si (P < 0.05) but was not related to AIR. Visceral fat was independently and positively related to fasting insulin (P < 0.05) and AIR (P < 0.01) and negatively related to Si (P < 0.001). CONCLUSIONS—These findings support the hypothesis that specific accumulation of visceral fat in addition to overall adiposity in Hispanic children increases the risk of type 2 diabetes.