Abstract

Background/ObjectivesMechanisms of obesity-associated insulin resistance and dysglycemia in South Asians remain relatively unknown. The objective of this study was to detect subcutaneous (SAT) vs. visceral (VAT) adipose tissue characteristics and adipocytokines associated with obesity, insulin resistance, and dysglycemia in South Asian women.Subjects/MethodsThis was a hospital-based cross-sectional study conducted in Sri Lanka. Subjects comprised of 58 adult women who underwent routine abdominal surgeries. SAT and VAT were obtained from anterior abdominal wall and omentum, respectively. Measures of adiposity, serum insulin and glucose, SAT and VAT crown-like structures (CLS), macrophages, resistin by immunohistochemistry, mean adipocyte area (MAA), and serum adipocytokines were examined.ResultsThe homeostatic model assessment for insulin resistance (HOMA-IR) score significantly correlated with age and waist circumference (WC), but not with body mass index (BMI). Although the number of CLS positively correlated with BMI, there were no significant differences between the number of CLS in women with normal fasting glucose (NFG) vs. those with impaired fasting glucose (IFG), indicating that adipose tissue macrophage infiltration is unlikely to be related to dysglycemia. In contrast, serum resistin level was on average 60% higher in women with IFG compared to ones with NFG (p < 0.05). Serum resistin levels correlated with age (r = 0.36, p < 0.05) and WC (r = 0.27, p < 0.05). There were no associations in serum levels of other adipocytokines with IFG. Adipose immunohistochemistry showed that women with IFG had a higher percentage of resistin positive adipocytes in SAT compared to ones with NFG. MAA of VAT, but not SAT, correlated with both BMI and WC.ConclusionsResistin may be an important adipokine linking central adiposity and insulin resistance in South Asian women. Both systemic and adipose tissue resistin are linked to dysglycemia in these individuals and may be a potential biomarker for diabetes in this population.

Highlights

  • Type-2 diabetes mellitus (T2DM) is a major health problem in the world as well as in South Asia[1]

  • The homeostatic model assessment for insulin resistance (HOMA-IR) score significantly correlated with age and waist circumference (WC), but not with body mass index (BMI)

  • The number of crown-like structures (CLS) positively correlated with BMI, there were no significant differences between the number of CLS in women with normal fasting glucose (NFG) vs. those with impaired fasting glucose (IFG), indicating that adipose tissue macrophage infiltration is unlikely to be related to dysglycemia

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Summary

Introduction

Type-2 diabetes mellitus (T2DM) is a major health problem in the world as well as in South Asia[1]. Especially visceral adiposity, is a major risk factor for insulin resistance and Nutrition and Diabetes. Obese individuals develop insulin resistance, which is attributed to (A) a chronic low-grade inflammation in white adipose tissue, (B) dysregulation of adipocytokine secretion, and (C) ectopic lipid deposition and lipotoxicity[4]. While mechanisms responsible for dysglycemia and insulin resistance have been studied in detail in western populations, these mechanisms have hitherto been unexplored in detail in South Asians[5]. Individuals of South Asian descent have a higher risk of developing T2DM for a given body mass index (BMI) compared to Caucasians. It is likely that different mechanisms operate in the pathogenesis of obesity-associated insulin resistance and dysglycemia in South Asians[5]. It is especially important to dissect these mechanisms given the recent escalation of obesity[6] and its co-morbidities in this region[7]

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