ORIGINAL ARTICLE

FAT DEPOSITION IN THE NUCHAL REGION IS ASSOCIATED WITH INSULIN RESISTANCE AND LOW METABOLIC CLEARANCE RATE OF GLUCOSE IN ADULT MALES

Kehinde Sola Akinlade , Abosede Olabimpe Ayinde, Sheu Kadiri Rahamon, Rasaki A Sanusi

Kehinde Sola Akinlade
Metabolic Research Unit, Department of Chemical Pathology, College of Medicine, University of Ibadan & University College Hospital, Ibadan, Nigeria.. Email: ksakinlade@yahoo.co.uk

Abosede Olabimpe Ayinde
Department of Chemical Pathology, University of Ibadan

Sheu Kadiri Rahamon
Department of Chemical Pathology, University of Ibadan

Rasaki A Sanusi
Department of Human Nutrition, University of Ibadan
Online First: July 15, 2020 | Cite this Article
Akinlade, K., Ayinde, A., Rahamon, S., Sanusi, R. 2020. FAT DEPOSITION IN THE NUCHAL REGION IS ASSOCIATED WITH INSULIN RESISTANCE AND LOW METABOLIC CLEARANCE RATE OF GLUCOSE IN ADULT MALES. Diabesity 6(3). DOI:10.15562/diabesity.2020.65


Background: The role of classical proxies for obesity such as the body mass index (BMI) and waist circumference (WC) in the development of insulin resistance (IR) is well reported. However, there is the dearth of information on the association between subcutaneous fat deposition in the nuchal region and the development of IR.

Objective: This study determined the interplay between thickness of cervical fat fold (CFF) and development of IR.

Methods: Fifty adult males with CFF and 50 males without CFF were enrolled into this study. Standard Oral Glucose Tolerance Testing (OGTT) was performed and fasting plasma glucose (FPG), 2 hours post prandial glucose (2hrPPG), lipids, fasting insulin (FI), 2 hours postprandial insulin (2hrPPI) levels were determined. Thereafter, indices of IR and estimated metabolic clearance rate of glucose (eMCR) were calculated using standard formula.

Results: Levels of FI, 2hrPPI and the median values of indices of IR were significantly higher while median values of indices of insulin sensitivity and eMCR were significantly lower in CFF compared with the controls. Predicting the diagnostic property of CFF for insulin sensitivity with reference to Quantitative Insulin Sensitivity Check Index (QUICKI) cut-off values, the Area Under the Receiver Operating Characteristic Curve (AUROC) was 0.695 (P-value = 0.043) and a CFF cut-off value of 12.5 cm had 75% sensitivity and 55.3% specificity.

Conclusion: Adult males with CFF have IR and low eMCR and are thus, prone to developing cardiovascular and metabolic diseases. Also, CFF thickness appears to be a good anthropometric index of insulin resistance.

References

Małodobra-Mazur M, Alama A, Bednarska-Chabowska D, Pawelka D, Myszczyszyn A, Dobosz T. Obesity-induced Insulin Resistance via Changes in the DNA Methylation Profile of Insulin Pathway Genes. Adv Clin Exp Med 2019; 28(12):1599-1607. doi: 10.17219/acem/110321.

Shulman GI. Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. N Engl J Med 2014; 371(12):1131-1141. doi: 10.1056/NEJMra1011035

Liu L, Feng J, Zhang G, Yuan X, Li F, Yange T et al. Visceral adipose tissue is more strongly associated with insulin resistance than subcutaneous adipose tissue in Chinese subjects with pre-diabetes. Curr Med Res Opin 2018; 34(1):123-129. doi: 10.1080/03007995.2017.1364226

Lalia AZ, Dasari S, Johnson ML, Robinson MM, Konopka AR, Distelmaier K et al. Predictors of Whole-Body Insulin Sensitivity Across Ages and Adiposity in Adult Humans. J Clin Endocrinol Metab 2016; 101(2):626-634. doi: 10.1210/jc.2015-2892

Gonzalez N, Moreno-Villegas Z, Gonzalez-Bris A, Egido J, Lorenzo Ó. Regulation of visceral and epicardial adipose tissue for preventing cardiovascular injuries associated to obesity and diabetes. Cardiovasc Diabetol 2017;16(1):44. doi: 10.1186/s12933-017-0528-4

Nielsen S, Guo Z, Johnson CM, Hensrud DD, Jensen MD. Splanchnic lipolysis in human obesity. J Clin Invest 2004; 113(11):1582-1588. doi: 10.1172/JCI21047

Preis SR, Massaro JM, Hoffmann U, D'Agostino Sr RB, Levy D, Robins SJ et al. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. J Clin Endocrinol Metab 2010; 95(8):3701-3710. doi: 10.1210/jc.2009-1779

Stabe C, Vasques ACJ, Lima MMO, Tambascia MA, Pareja JC, Yamanaka A et al. Neck circumference as a simple tool for identifying the metabolic syndrome and insulin resistance: results from the Brazilian Metabolic Syndrome Study. Clin Endocrinol (Oxf) 2013; 78(6):874-881. doi: 10.1111/j.1365-2265.2012.04487.x.

Britton KA, Massaro JM, Murabito JM, Kreger BE, Hoffmann U, Fox CS. Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality. J Am Coll Cardiol 2013; 62(10):921-925. doi: 10.1016/j.jacc.2013.06.027

Kihara S, Matsuzawa Y. Fat distribution and cardiovascular disease risk. Curr Cardiovasc Risk Rep 2015; 9(3):8. https://doi.org/10.1007/s12170-015-0439-4

Fan H, Li X, Zheng L, Chen X, Lan Q, Wu H et al. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Sci Rep 2016; 6:21521. doi: 10.1038/srep21521.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18(6):499-502.

Muniyappa R, Lee S, Chen H, Quon MJ. Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab 2008; 294(1):E15-E26. doi: 10.1152/ajpendo.00645.2007

Stumvoll M, Van Haeften T, Fritsche A, Gerich J. Oral glucose tolerance test indexes for insulin sensitivity and secretion based on various availabilities of sampling times. Diabetes Care 2001; 24(4):796-797. doi: 10.2337/diacare.24.4.796.

Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005; 115(4):e500-503. doi: 10.1542/peds.2004-1921.

Ginsberg HN. Insulin resistance and cardiovascular disease. J Clin Invest 2000; 106(4):453-458. doi: 10.1172/JCI10762.

Argiles JM, Lopez-Soriano FJ. Insulin and cancer. Int J Oncol 2001; 18(4):683-687. https://doi.org/10.3892/ijo.18.4.683

Zhang Y, Lee ET, Howard BV, Best LG, Umans JG, Yeh J et al. Insulin resistance, incident cardiovascular diseases, and decreased kidney function among nondiabetic American Indians: the Strong Heart Study. Diabetes Care 2013; 36(10):3195-3200. doi: 10.2337/dc12-2368

McFarlane SI, Banerji M, Sowers JR. Insulin Resistance and Cardiovascular Disease. J Clin Endocrinol Metab 2001; 86(2):713-718. doi: 10.1210/jcem.86.2.7202.

Ferreira AP, Oliveira C, França NM. Metabolic syndrome and risk factors for cardiovascular disease in obese children: the relationship with insulin resistance (HOMA-IR). J Pediatr (Rio J) 2007; 83(1):21-26. doi: 10.2223/JPED.1562.

Wilcox G. Insulin and insulin resistance. Clin Biochem Rev 2005; 26(2):19.

Revers RR, Kolterman OG, Olefsky JM. Relationship between serum glucose level and the metabolic clearance rate of glucose in non-insulin-dependent diabetes mellitus. Diabetes 1983; 32(7):627-632. doi: 10.2337/diab.32.7.627.

Stumvoll M, Mitrakou A, Pimenta W, Jenssen T, Yki-Järvinen H, Van Haeftene T et al. Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity. Diabetes Care 2000; 23(3):295-301. doi: 10.2337/diacare.23.3.295.

Lee CC, Haffner SM, Wagenknecht LE, Lorenzo C, Norris JM, Bergman RN et al. Insulin clearance and the incidence of type 2 diabetes in Hispanics and African Americans: the IRAS Family Study. Diabetes Care 2013; 36(4):901-907. doi: 10.2337/dc12-1316

Akinlade KS, Rahamon SK, Lasebikan VO. Beta-cell Function and Metabolic Clearance Rate of Glucose in Patients with Major Mental Health Disorders on Antipsychotic Drug Treatment. J Natl Med Assoc 2018; 110(5):504-511. doi: 10.1016/j.jnma.2018.01.003.


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