MODIFICATIONS OF ABDOMINAL FAT AND HEPATIC INSULIN-CLEARANCE DURING SEVERE CALORIC RESTRICTION

Using computed tomography on 19 obese female subjects, we determined abdominal adipose tissue, both subcutaneous and visceral adipose tissue, before and after 2 weeks of a very low caloric diet (VLCD). The following parameters were also determined before and after 15-20 days of VLCD: plasma glucose and insulin levels, oral glucose tolerance test, basal pancreatic insulin secretion estimated by fasting C peptide (Cp), and fasting insulin hepatic clearance calculated by Cp/insulin molar ratio. After VLCD the body weight and body mass index significantly declined (p < 0.01); whereas abdominal adipose tissue and visceral abdominal tissue (VAT) significantly decreased (p < 0.01), modifcations of subcutaneus abdominal tissue (SAT) were not significant. Fasting insulin levels and plasma glucose response to oral glucose load significantly decreased (p < 0.05). Insulin response remained unchanged. Cp immunoreactive insulin (IRI) significantly increased (p < 0.01). A significant positive correlation was found between △VAT and △Cp/IRI before and after VLCD (p < 0.01). Our data seem to suggest that the weight loss induced by VLCD fundamentally involves a decrease in VAT. The reduction in visceral fat could be associated with an increase in hepatic insulin clearance. © 1990 S. Karger AG, Basel.