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ABSTRACT OBJECTIVE: Central fat mass (CFM) correlates with insulin resistance and increases the risk of type 2 diabetes and cardiovascular complications. On the other hand, increased

peripheral fat mass (PFM) is associated with higher insulin sensitivity. Thus, we examined the contribution of adipose tissue distribution, as assessed by the PFM/CFM ratio, to insulin

sensitivity in overweight and obese postmenopausal women. DESIGN AND METHODS: A total of 124 nondiabetic overweight and obese postmenopausal women underwent an oral glucose tolerance test

(OGTT) and a hyperinsulinemic/euglycemic (HI) clamp. Body composition was determined using computed tomography for visceral adipose tissue (VAT) and dual X-ray absorptiometry for fat mass,

lean body mass and their respective proportions. Participants were divided by tertiles of the PFM/CFM ratio. RESULTS: Participants with preferential CFM (group 1) had higher fasting insulin

levels and insulin area under the curve (AUC) during OGTT, as well as lower glucose infusion rates during the HI clamp, whether it was expressed per kg of body weight (M) or per kg of

fat-free mass (Mm), compared with the other two groups. The PFM/CFM ratio also correlated significantly with fasting insulin (_r_=−0.32, _P_<0.001), the insulin AUC (_r_=−0.42

_P_<0.001), M (_r_=0.39 _P_<0.001) and Mm (_r_=0.37 _P_<0.001). Using hierarchical regression, we demonstrated that the PFM/CFM ratio was an independent predictor of insulin AUC, M

and Mm and that its sequential addition to CFM and VAT improved significantly the predictive value of the model for insulin sensitivity for all variables except fasting insulin. CONCLUSION:

The PFM/CFM ratio, which integrates the antagonistic effects of both central and peripheral depots on insulin sensitivity, added substantially to the prediction of insulin sensitivity over

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Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ADIPOSE TISSUE INSULIN RESISTANCE INDEX WAS INVERSELY ASSOCIATED WITH GLUTEOFEMORAL FAT AND SKELETAL MUSCLE MASS IN JAPANESE

WOMEN Article Open access 16 July 2024 DISTINCT OPPOSING ASSOCIATIONS OF UPPER AND LOWER BODY FAT DEPOTS WITH METABOLIC AND CARDIOVASCULAR DISEASE RISK MARKERS Article 30 July 2021 ADIPOSE

TISSUE INSULIN RESISTANCE PREDICTS THE INCIDENCE OF HYPERTENSION: THE HIROSHIMA STUDY ON GLUCOSE METABOLISM AND CARDIOVASCULAR DISEASES Article 10 August 2022 REFERENCES * Despres JP,

Lemieux I . Abdominal obesity and metabolic syndrome. _Nature_ 2006; 444: 881–887. Article  CAS  Google Scholar  * Ferrannini E, Natali A, Bell P, Cavallo-Perin P, Lalic N, Mingrone G .

Insulin resistance and hypersecretion in obesity. European Group for the Study of Insulin Resistance (EGIR). _J Clin Invest_ 1997; 100: 1166–1173. Article  CAS  Google Scholar  * Karelis AD,

Brochu M, Rabasa-Lhoret R, Garrel D, Poehlman ET . Clinical markers for the identification of metabolically healthy but obese individuals. _Diabetes Obes Metab_ 2004; 6: 456–457. Article 

CAS  Google Scholar  * Conus F, Rabasa-Lhoret R, Peronnet F . Characteristics of metabolically obese normal-weight (MONW) subjects. _Appl Physiol Nutr Metab_ 2007; 32: 4–12. Article  Google

Scholar  * Bonora E, Kiechl S, Willeit J, Oberhollenzer F, Egger G, Targher G _et al_. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study. _Diabetes_ 1998; 47:

1643–1649. Article  CAS  Google Scholar  * Karelis AD, Faraj M, Bastard JP, St-Pierre DH, Brochu M, Prud'homme D _et al_. The metabolically healthy but obese individual presents a

favorable inflammation profile. _J Clin Endocrinol Metab_ 2005; 90: 4145–4150. Article  CAS  Google Scholar  * Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC . Obesity, fat

distribution, and weight gain as risk factors for clinical diabetes in men. _Diabetes Care_ 1994; 17: 961–969. Article  CAS  Google Scholar  * Kissebah AH, Peiris AN . Biology of regional

body fat distribution: relationship to non-insulin-dependent diabetes mellitus. _Diabetes Metab Rev_ 1989; 5: 83–109. Article  CAS  Google Scholar  * Despres JP . Is visceral obesity the

cause of the metabolic syndrome? _Ann Med_ 2006; 38: 52–63. Article  CAS  Google Scholar  * Folsom AR, Stevens J, Schreiner PJ, McGovern PG . Body mass index, waist/hip ratio, and coronary

heart disease incidence in African Americans and whites. Atherosclerosis Risk in Communities Study Investigators. _Am J Epidemiol_ 1998; 148: 1187–1194. Article  CAS  Google Scholar  *

Megnien JL, Denarie N, Cocaul M, Simon A, Levenson J . Predictive value of waist-to-hip ratio on cardiovascular risk events. _Int J Obes Relat Metab Disord_ 1999; 23: 90–97. Article  CAS 

Google Scholar  * Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P _et al_. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a

case–control study. _Lancet_ 2005; 366: 1640–1649. Article  Google Scholar  * Snijder MB, Visser M, Dekker JM, Goodpaster BH, Harris TB, Kritchevsky SB _et al_. Low subcutaneous thigh fat is

a risk factor for unfavourable glucose and lipid levels, independently of high abdominal fat. The Health ABC Study. _Diabetologia_ 2005; 48: 301–308. Article  CAS  Google Scholar  *

Paradisi G, Smith L, Burtner C, Leaming R, Garvey WT, Hook G _et al_. Dual energy X-ray absorptiometry assessment of fat mass distribution and its association with the insulin resistance

syndrome. _Diabetes Care_ 1999; 22: 1310–1317. Article  CAS  Google Scholar  * Gan SK, Kriketos AD, Poynten AM, Furler SM, Thompson CH, Kraegen EW _et al_. Insulin action, regional fat, and

myocyte lipid: altered relationships with increased adiposity. _Obes Res_ 2003; 11: 1295–1305. Article  CAS  Google Scholar  * Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E,

Obesity Canada Clinical Practice Guidelines Expert Panel. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. _CMAJ_

2007; 176: S1–S13. Article  Google Scholar  * Balkau B, Deanfield JE, Després JP, Bassand JP, Fox KA, Smith Jr SC _et al_. International Day for the Evaluation of Abdominal Obesity (IDEA): a

study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. _Circulation_ 2007; 116: 1942–1951. Article  Google Scholar  *

Bastard JP, Vandernotte JM, Faraj M, Karelis AD, Messier L, Malita FM _et al_. Relationship between the hyperinsulinemic-euglycaemic clamp and a new simple index assessing insulin

sensitivity in overweight and obese postmenopausal women. _Diabetes Metab_ 2007; 33: 261–268. Article  CAS  Google Scholar  * Karelis AD, Tousignant B, Nantel J, Proteau-Labelle M, Malita

FM, St-Pierre DH _et al_. Association of insulin sensitivity and muscle strength in overweight and obese sedentary postmenopausal women. _Appl Physiol Nutr Metab_ 2007; 32: 297–301. Article

  CAS  Google Scholar  * American Diabetes Association. Screening for Diabetes. _Diabetes Care_ 2002; 25: 21S–24S. * DeFronzo RA, Tobin JD, Andres R . Glucose clamp technique: a method for

quantifying insulin secretion and resistance. _Am J Physiol_ 1979; 237: E214–E223. CAS  Google Scholar  * Smith Jr SC . Multiple risk factors for cardiovascular disease and diabetes

mellitus. _Am J Med_ 2007; 120 (3 Suppl 1): S3–S11. Article  Google Scholar  * Sowers JR . Obesity as a cardiovascular risk factor. _Am J Med_ 2003; 115 (Suppl 8A): 37S–41S. Article  CAS 

Google Scholar  * McFarlane SI, Banerji M, Sowers JR . Insulin resistance and cardiovascular disease. _J Clin Endocrinol Metab_ 2001; 86: 713–718. CAS  PubMed  Google Scholar  * Lissner L,

Björkelund C, Heitmann BL, Seidell JC, Bengtsson C . Larger hip circumference independently predicts health and longevity in a Swedish female cohort. _Obes Res_ 2001; 9: 644–646. Article 

CAS  Google Scholar  * Tanko LB, Bagger YZ, Alexandersen P, Larsen PJ, Christiansen C . Central and peripheral fat mass have contrasting effect on the progression of aortic calcification in

postmenopausal women. _Eur Heart J_ 2003; 24: 1531–1537. Article  Google Scholar  * Snijder MB, Dekker JM, Visser M, Bouter LM, Stehouwer CD, Yudkin JS _et al_. Hoorn study. Trunk fat and

leg fat have independent and opposite associations with fasting and postload glucose levels: the Hoorn study. _Diabetes Care_ 2004; 27: 372–377. Article  Google Scholar  * Ferreira I,

Snijder MB, Twisk JW, van Mechelen W, Kemper HC, Seidell JC _et al_. Central fat mass versus peripheral fat and lean mass: opposite (adverse versus favorable) associations with arterial

stiffness? The Amsterdam Growth and Health Longitudinal Study. _J Clin Endocrinol Metab_ 2004; 89: 2632–2639. Article  CAS  Google Scholar  * Van Pelt RE, Evans EM, Schechtman KB, Ehsani AA,

Kohrt WM . Contributions of total and regional fat mass to risk for cardiovascular disease in older women. _Am J Physiol Endocrinol Metab_ 2002; 282: E1023–E1028. Article  CAS  Google

Scholar  * Wajchenberg BL . Subcutaneous and visceral adipose tissue: their relation to the metabolic syndrome. _Endocr Rev_ 2000; 21: 697–738. Article  CAS  Google Scholar  * Abdul-Ghani

MA, Matsuda M, Balas B, DeFronzo RA . Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test. _Diabetes Care_ 2007; 30: 89–94. Article  CAS  Google Scholar

  * Mulligan K, Grunfeld C, Tai VW, Algren H, Pang M, Chernoff DN _et al_. Hyperlipidemia and insulin resistance are induced by protease inhibitors independent of changes in body composition

in patients with HIV infection. _J Acquir Immune Defic Syndr_ 2000; 23: 35–43. Article  CAS  Google Scholar  * Kahn SE, Haffner SM, Heise MA, Herman WH, Holman RR, Jones NP _et al_. ADOPT

Study Group. Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy. _N Engl J Med_ 2006; 355: 2427–2443. Article  CAS  Google Scholar  * Yang X, Smith U . Adipose tissue

distribution and risk of metabolic disease: does thiazolidinedione-induced adipose tissue redistribution provide a clue to the answer? _Diabetologia_ 2007; 50: 1127–1139. Article  CAS 

Google Scholar  * Akazawa S, Sun F, Ito M, Kawasaki E, Eguchi K . Efficacy of troglitazone on body fat distribution in type 2 diabetes. _Diabetes Care_ 2000; 23: 1067–1071. Article  CAS 

Google Scholar  * Kawai T, Takei I, Oguma Y, Ohashi N, Tokui M, Oguchi S _et al_. Effects of troglitazone on fat distribution in the treatment of male type 2 diabetes. _Metabolism_ 1999; 48:

1102–1107. Article  CAS  Google Scholar  * Smith SR, De Jonge L, Volaufova J, Li Y, Xie H, Bray GA . Effect of pioglitazone on body composition and energy expenditure: a randomized

controlled trial. _Metabolism_ 2005; 54: 24–32. Article  CAS  Google Scholar  * Paniagua J, Gallego de la Sacristana A, Romero I, Vidal-Puig A, Latre JM, Sanchez E _et al_. MUFA-rich diet

prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects. _Diabetes Care_ 2007; 30:

1717–1723. Article  CAS  Google Scholar  * Smith U . Regional differences in adipocyte metabolism and possible consequences _in vivo_. _Int J Obes_ 1985; 9 (Suppl 1): 145–148. CAS  PubMed 

Google Scholar  * Rebuffe-Scrive M, Enk L, Crona N, Lönnroth P, Abrahamsson L, Smith U _et al_. Fat cell metabolism in different regions in women. Effect of menstrual cycle, pregnancy, and

lactation. _J Clin Invest_ 1985; 75: 1973–1976. Article  CAS  Google Scholar  * Prentki M, Nolan CJ . Islet {beta} cell failure in type 2 diabetes. _J Clin Invest_ 2006; 116: 1802–1812.

Article  CAS  Google Scholar  * Havel PJ . Update on adipocyte hormones: regulation of energy balance and carbohydrate/lipid metabolism. _Diabetes_ 2004; 53 (Suppl 1): S143–S151. Article 

CAS  Google Scholar  * Lihn AS, Bruun JM, He G, Pedersen SB, Jensen PF, Richelsen B . Lower expression of adiponectin mRNA in visceral adipose tissue in lean and obese subjects. _Mol Cell

Endocrinol_ 2004; 219: 9–15. Article  CAS  Google Scholar  * Kelley DE . Skeletal muscle triglycerides: an aspect of regional adiposity and insulin resistance. _Ann NY Acad Sci_ 2002; 967:

135–145. Article  CAS  Google Scholar  Download references ACKNOWLEDGEMENTS Rémi Rabasa-Lhoret holds Fonds de la recherche en santé du Québec (FRSQ) research scholar grants. May Faraj is a

recipient of the Canadian Institutes of Health Research (CIHR) New Investigator Award. This study was supported by grants from the CIHR New Emerging Teams in Obesity (Université de Montréal

and University of Ottawa; the MONET project) and a CIHR Operating Grant. We thank Lyne Messier for coordinating this study, Miguel Chagnon for his precious advice on statistical analyses and

Stéphanie Chevalier for critical reading of the manuscript. The editorial assistance of Mr Ovid Da Silva, Research Support Office, Research Centre, Centre hospitalier de l'Université

de Montréal (CHUM), is acknowledged. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada B

Tousignant, M Faraj, D Garrel, R Rabasa-Lhoret & L Coderre * Research Center, Centre hospitalier de l'Université de Montréal (CHUM)–Hôtel-Dieu, Montreal, Quebec, Canada M Faraj, D

Garrel, R Rabasa-Lhoret & L Coderre * Montreal Diabetes Research Centre, Centre hospitalier de l'Université de Montréal (CHUM)–Hôtel-Dieu, Montreal, Quebec, Canada M Faraj, R

Rabasa-Lhoret & L Coderre * Department of Kinesiology, Université de Montréal, Montreal, Quebec, Canada F Conus * Health and Social Services Centre—Sherbrooke Geriatrics University

Institute, University of Sherbrooke, Sherbrooke, Quebec, Canada M Brochu * Faculty of Physical Education and Sports, University of Sherbrooke, Sherbrooke, Quebec, Canada M Brochu *

Department of Medicine, Université de Montréal, Montreal, Quebec, Canada L Coderre Authors * B Tousignant View author publications You can also search for this author inPubMed Google Scholar

* M Faraj View author publications You can also search for this author inPubMed Google Scholar * F Conus View author publications You can also search for this author inPubMed Google Scholar

* D Garrel View author publications You can also search for this author inPubMed Google Scholar * M Brochu View author publications You can also search for this author inPubMed Google

Scholar * R Rabasa-Lhoret View author publications You can also search for this author inPubMed Google Scholar * L Coderre View author publications You can also search for this author

inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to R Rabasa-Lhoret. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tousignant, B., Faraj,

M., Conus, F. _et al._ Body fat distribution modulates insulin sensitivity in post-menopausal overweight and obese women: a MONET study. _Int J Obes_ 32, 1626–1632 (2008).

https://doi.org/10.1038/ijo.2008.163 Download citation * Received: 18 April 2008 * Revised: 24 July 2008 * Accepted: 19 August 2008 * Published: 07 October 2008 * Issue Date: November 2008 *

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currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * insulin resistance * hyperinsulinemic/euglycemic clamp

* abdominal fat * peripheral fat * visceral adipose tissue