Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship between Visceral Adiposity Index, Insulin Resistance and Pancreatic Beta Cell Function According to the Prevalence of Metabolic Syndrome in Korean Obese Adults

한국 비만성인의 대사증후군 유병에 따른 내장지방지수와 인슐린저항성, 췌장 베타세포기능과의 관련성

  • Shin, Kyung-A (Dept. of Clinical Laboratory Science, Shinsung University)
  • Received : 2020.06.15
  • Accepted : 2020.09.20
  • Published : 2020.09.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate the relationship between VAI, insulin resistance, and pancreatic beta cell function according to the prevalence of metabolic syndrome in obese adults. From 2017 to 2019, 1,797 obese adults who received medical checkups at a general hospital in Bundang. Diagnosis of metabolic syndrome is NCEP-ATP III. HOMA index was used for insulin resistance and pancreatic beta cell function. VAI was higher in the metabolic syndrome than in the control(p<.001). As the number of risk factors for metabolic syndrome increased, the VAI value was higher(p<.001). The prevalence of metabolic syndrome increased as the VAI quartile increased(p<.001). VAI was also shown to be related to HOMA-IR and HOMA-β in the control, but not in the metabolic syndrome.

본 연구는 비만성인을 대상으로 대사증후군 유병에 따라 VAI와 인슐린저항성, 췌장 베타세포기능과의 관련성을 알아보고자 하였다. 2017년 1월부터 2019년 12월까지 분당지역 일개 종합병원에서 건강검진을 받은 만 19세 이상 비만성인 1,797명을 대상으로 분석하였다. 대사증후군은 NCEP-ATP III의 기준에 근거하였다. 인슐린저항성 및 췌장 베타세포기능은 HOMA 지수를 이용하였다. 대조군보다 대사증후군 진단군에서 VAI가 높았으며, 대사증후군 위험요인 개수가 증가할수록 높은 VAI값을 보였다(각각 p<.001). 또한 VAI 사분위수가 증가함에 따라 대사증후군 유병률이 증가하였다(p<.001). VAI는 대조군에서 HOMA-IR 및 HOMA-β와 관련이 있는 것으로 나타났으나, 대사증후군 진단군에서는 HOMA-IR 및 HOMA-β간에 관련이 없었다.

Keywords

References

  1. S. E. Kah, R. L. Hull & K. M. Utzschneider. (2006). Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature, 444(7121), 840-846. DOI : 10.1038/nature05482
  2. D. Canoy et al. (2007). Body fat distribution and risk of coronary heart disease in men and women in the European prospective investigation into cancer and nutrition in Norfolk Cohort: a population-based prospective study. Circulation, 116(25), 2933-2943. DOI : 10.1161/CIRCULATIONAHA.106.673756
  3. M. Lee & L. J. Aronne. (2007). Weight management for type 2 diabetes mellitus: global cardiovascular risk reduction. American Journal of Cardiology, 99(4), 68-79. DOI : 10.1016/j.amjcard.2006.11.007
  4. A. Shuster, M. Patlas, J. H. Pinthus & M. Mourtzakis. (2012). The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. The British Journal of Radiology, 85(1009), 1-10. DOI : 10.1259/bjr/38447238
  5. K. M. Knowles et al. (2011). Waist circumference, body mass index, and other measures of adiposity in predicting cardiovascular disease risk factors among Peruvian adults. International Journal of Hypertension, 24, 931402. DOI : 10.4061/2011/931402
  6. M. C. Pouliot et al. (1994). Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. American Journal of Cardiology, 73(7), 460-468. DOI : 10.1016/0002-9149(94)90676-9
  7. M. C. Amato et al. (2010). Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic Risk. Diabetes Care, 33(4), 920-922. DOI : 10.2337/dc09-1825
  8. T. Du, X. Sun, R. Huo & X. Yu. (2014). Visceral adiposity index, hypertriglyceridemic waist and risk of diabetes: the china health and nutrition survey 2009. International Journal of Obesity, 38(6), 840-847. DOI : 10.1038/ijo.2013.181
  9. J. Y. Oh, Y. A. Sung & H. J. Lee. (2013). The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity (Silver Spring), 21(8), 1690-1694. DOI : 10.1002/oby.20096
  10. G. A. Balsan, J. L. da Costa Vieira, A. M. de Oliveira & V. L. Portal. (2015). Relationship between adiponectin, obesity and insulin resistance. Revista da Associacao Medica Brasileira (1992), 61(1), 72-80. DOI : 10.1590/1806-9282.61.01.072
  11. S. E. Kahn. (2003). The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia, 46(1), 3-19. DOI : 10.1007/s00125-002-1009-0
  12. G. Kloppel, M. Lohr, K. Habich, M. Oberholzer & P. U. Heitz. (1985). Islet pathology and the pathogenesis of type 1 and type 2 diabetes mellitus revisited. Survey and Synthesis of Pathology Research, 4(2), 110-125. DOI : 10.1159/000156969
  13. B. L. Wajchenberg. (2007). Beta-cell failure in diabetes and preservation by clinical treatment. Endocrine Reviews, 28(2), 187-218. DOI : 10.1210/10.1210/er.2006-0038
  14. D. R. Matthews, J. P. Hosker, A. S. Rudenski, B. A. Naylor, D. F. Treacher & R. C. Turner. (1985). Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28(7), 412-419. DOI : 10.1007/BF00280883
  15. S. Cernea & M. Dobreanu. (2013). Diabetes and beta cell function: from mechanisms to evaluation and clinical implications. Biochemia Medica, 23(3), 266-280. DOI : 10.11613/bm.2013.033
  16. M. Bozorgmanesh, F. Hadaegh & F. Azizi. (2010). Predictive performances of lipid Accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: tehran lipid and glucose study. Lipids in Health and Disease, 16(9), 100. DOI : 10.1186/1476-511X-9-100
  17. N. M. Al-Daghri et al. (2013). Visceral adiposity index is highly associated with adiponectin values and glycaemic disturbances. European Journal of Clinical Investigation, 43(2), 183-189. DOI : 10.1111/eci.12030
  18. M. Stepien et al. (2014). New obesity indices and adipokines in normotensive patients and patients with hypertension: comparative pilot analysis. Angiology, 65(4), 333-342. DOI : 10.1177/0003319713485807
  19. K. A. Shin & Y. J. Kim. (2019). Usefulness of surrogate markers of body fat distribution for predicting metabolic syndrome in middle-aged and older Korean populations. Diabetes, Metabolic Syndrome and Obesity, 12, 2251-2259. DOI : 10.2147/DMSO.S217628
  20. S. W. Oh, S. A. Shin, Y. H. Yun, T. W. Yoo & B. Y. Huh. (2004). Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans. Obesity Research, 12(12), 2031-2040. DOI : 10.1038/oby.2004.254
  21. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2001). Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). The Journal of the American Medical Association, 285(19), 2486-2497. DOI : 10.1001/jama.285.19.2486
  22. World Health Organization. (2000). The Asia-Pacific perspective: redefining obesity and its treatment. Sydney : Health Communications Australia.
  23. S. Lee et al. (2006). Cutoff values of surrogate measures of insulin resistance for metabolic syndrome in Korean non-diabetic adults. Journal of Korean Medical Science, 21(4), 695-700. DOI : 10.3346/jkms.2006.21.4.695
  24. Y. Song et al. (2007). Insulin sensitivity and insulin secretion determined by homeostasis model assessment and risk of diabetes in a multiethnic cohort of women: the women's health initiative observational study. Diabetes Care, 30(7), 1747-1752. DOI : 10.2337/dc07-0358
  25. E. E. Calle & R. Kaaks. (2004). Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nature Reviews Cancer, 4(8), 579-591. DOI : 10.1038/nrc1408
  26. B. M. Popkin, L. S. Adair & S. W. Ng. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews, 70(1), 3-21. DOI : 10.1111/j.1753-4887.2011.00456.x
  27. J. P. Despres & I. Lemieux. (2006). Abdominal obesity and metabolic syndrome. Nature, 444(7121), 881-887. DOI : 10.1038/nature05488
  28. E. Mazzuca et al. (2014). Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea. Journal of Sleep Research, 23(1), 13-21. DOI : 10.1111/jsr.12088
  29. B. Elisha et al. (2013). The visceral adiposity index: relationship with cardiometabolic risk factors in obese and overweight postmenopausal women-a MONET group study. Applied Physiology, Nutrition, and Metabolism, 38(8), 892-899. DOI : 10.1139/apnm-2012-0307
  30. L. Ramalingam et al. (2017). The renin angiotensin system, oxidative stress and mitochondrial function in obesity and insulin resistance. Biochimica et Biophysica Acta-Molecular Basis of Disease, 1863(5), 1106-1114. DOI : 10.1016/j.bbadis.2016.07.019
  31. N. S. Kalupahana & N. Moustaid-Moussa. (2012). The renin-angiotensin system: a link between obesity, inflammation and insulin resistance. Obesity Reviews, 13(2), 136-149. DOI : 10.1111/j.1467-789X.2011.00942.x
  32. M. K. Garg, M. K. Dutta & N. Mahalle. (2011). Study of beta-cell function (by HOMA model) in metabolic syndrome. Indian Journal of Endocrinology and Metabolism, 15(1), 44-49. DOI : 10.4103/2230-8210.83059
  33. J. B. Dixon, A. F. Dixon & P. E. O'Brien. (2003). Improvements in insulin sensitivity and beta-cell function(HOMA) with weight loss in the severely obese. Homeostatic model assessment. Diabetic Medicine, 20(2), 127-134. DOI : 10.1046/j.1464-5491.2003.00889.x
  34. H. H. Sung et al. (2020). The association of the visceral adiposity index with insulin resistance and beta-cell function in Korean adults with and without type 2 diabetes mellitus. Endocrine Journal, 12. DOI : 10.1507/endocrj.EJ19-0517
  35. E. Ferrannini. (1998). Insulin resistance versus insulin deficiency in non-insulin-dependent diabetes mellitus: problems and prospects. Endocrine Reviews, 19(4), 477-490. DOI : 10.1210/edrv.19.4.0336
  36. M. Kasuga. (2006). Insulin resistance and pancreatic beta cell failure. Journal of Clinical Investigation, 116(7), 1756-1760. DOI : 10.1172/JCI29189