Abstract
Given the central role of skeletal muscles in glucose homeostasis, deposition of adipose depots beneath the fascia of muscles (versus subcutaneous adipose tissue [SAT]) may precede insulin resistance and type 2 diabetes (T2D) incidence. This study was aimed to investigate the associations between computed tomography (CT)-derived biomarkers for adipose tissue and T2D incidence in normoglycemic adults. This study was a population-based multiethnic retrospective cohort of 1,744 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with normoglycemia (baseline fasting plasma glucose [FPG] less than 100 mg/dL) from 6 United States of America communities. Participants were followed from April 2010 and January 2012 to December 2017, for a median of 7 years. The intermuscular adipose tissue (IMAT) and SAT areas were measured in baseline chest CT exams and were corrected by height squared (SAT and IMAT indices) using a predefined measurement protocol. T2D incidence, as the main outcome, was based on follow-up FPG, review of hospital records, or self-reported physician diagnoses. Participants' mean age was 69 ± 9 years at baseline, and 977 (56.0%) were women. Over a median of 7 years, 103 (5.9%) participants were diagnosed with T2D, and 147 (8.4%) participants died. The IMAT index (hazard ratio [HR]: 1.27 [95% confidence interval [CI]: 1.15-1.41] per 1-standard deviation [SD] increment) and the SAT index (HR: 1.43 [95% CI: 1.16-1.77] per 1-SD increment) at baseline were associated with T2D incidence over the follow-up. The associations of the IMAT and SAT indices with T2D incidence were attenuated after adjustment for body mass index (BMI) and waist circumference, with HRs of 1.23 (95% CI: 1.09-1.38) and 1.29 (95% CI: 0.96-1.74) per 1-SD increment, respectively. The limitations of this study include unmeasured residual confounders and one-time measurement of adipose tissue biomarkers. In this study, we observed an association between IMAT at baseline and T2D incidence over the follow-up. This study suggests the potential role of intermuscular adipose depots in the pathophysiology of T2D. ClinicalTrials.gov NCT00005487.
Highlights
Type 2 diabetes (T2D) affects more than 20 million new cases every year, and, in addition to the attributable high morbidity and mortality, imposes an increased financial burden on healthcare systems worldwide [1]
This study was designed to investigate the associations between computed tomography (CT)–derived biomarkers for adipose tissue at baseline and type 2 diabetes (T2D) incifinancial support of the study for participant recruitment and data collection
Out of the 3,083 participants in the MESArthritis Ancillary Study, 1,744 normoglycemic participants at baseline were included in this study (S1 Fig)
Summary
Type 2 diabetes (T2D) affects more than 20 million new cases every year, and, in addition to the attributable high morbidity and mortality, imposes an increased financial burden on healthcare systems worldwide [1]. Most of this burden can be avoided by early identification of at-risk individuals and the rapid implementation of primary and secondary preventive measures [2]. There are known associations between obesity or excessive overall adipose depots and the T2D incidence [3,4,5]. The body mass index (BMI) and other clinical anthropometric indices, despite quantifying the excessive overall adipose depots, do not provide data on ectopic adipose depots distribution
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
