Unique effect of visceral fat on insulin sensitivity in obese hispanic children with a family history of type 2 diabetes

OBJECTIVE - This study aimed to establish whether total fat or central fat was related to measures of insulin in obese Hispanic children with a family history of type 2 diabetes. RESEARCH DESIGN AND METHODS - Subjects were 32 children aged 8-13 years. Visceral fat and subcutaneous abdominal fat were determined by magnetic resonance imaging at the umbilicus and total body fat was determined by dual-energy X-ray absorptiometry. Insulin sensitivity (S-i) and acute insulin response (AIR) were determined by frequently sampled intravenous tolerance test with minimal modeling. RESULTS - Mean fasting glucose and insulin, S-i, and AIR (+/- SD) were 5.3 +/- 0.3 mmol/l, 206 +/- 105 pmol/l, 11.8 +/- 5.7 [X 10(-4) min(-1)/(pmol/l)], and 17,175 +/- 9,695 (pmol/l X 10 min), respectively. In multivariate regression analysis, total fat mass was independently and positively related to fasting insulin (P < 0.01) and negatively related to S-i (P < 0.05) but was not related to AIR. Visceral fat was independently and positively related to fasting insulin (P < 0.05) and AIR (P < 0.01) and negatively related to S-i (P < 0.001). CONCLUSIONS - These findings support the hypothesis that specific accumulation of visceral fat in addition to overall adiposity in Hispanic children increases the risk of type 2 diabetes.