Natural history of impaired glucose tolerance in Japanese Americans: Change in visceral adiposity is associated with remission from impaired glucose tolerance to normal glucose tolerance.
AIMS
To describe the roles of intra-abdominal fat and its change in the remission of impaired glucose tolerance (IGT) to normal glucose tolerance (NGT).


METHODS
We followed 157 Japanese Americans with IGT at baseline for 10-11 years without external intervention. We measured intra-abdominal and abdominal subcutaneous fat area (IAFA and ASFA) by computed tomography at baseline and at 5-6 years of follow-up. Change in IAFA and ASFA (ΔIAFA and ΔASFA) were calculated by subtracting baseline fat area from 5-6 year follow-up fat area. Glucose and insulin at fasting and during a 75-g oral glucose tolerance test, insulinogenic index (IGI [Δinsulin/Δglucose (30-0 min)]) and homeostasis model assessment for insulin resistance (HOMA-IR) were measured at baseline.


RESULTS
Fourty-four subjects remitted to NGT. Among those with lower IAFA (≤median 91.31 cm2) and the lowest tertile of ΔIAFA, 45% remitted, while with higher IAFA (>91.31 cm2) and the highest tertile of ΔIAFA, only 12.5% remitted. ΔIAFA was significantly associated with remission to NGT (multiple-adjusted odd ratio [1-SD decrease] 1.93, 95% CI 1.10-3.36) independent of IAFA, ASFA, ΔASFA, IGI, HOMA-IR, age, sex, and family history of diabetes.


CONCLUSIONS
In the natural history of IGT, change in intra-abdominal fat was associated with remission to NGT.
['Onishi|Yukiko|Y|', 'Hayashi|Tomoshige|T|', 'Sato|Kyoko K|KK|', 'Leonetti|Donna L|DL|', 'Kahn|Steven E|SE|', 'Fujimoto|Wilfred Y|WY|', 'Boyko|Edward J|EJ|']
D050154:Adiposity D000328:Adult D000368:Aged D001213:Asian Americans D001786:Blood Glucose D003920:Diabetes Mellitus D005260:Female D018149:Glucose Intolerance D005951:Glucose Tolerance Test D006801:Humans D007333:Insulin Resistance D008297:Male D008875:Middle Aged D012307:Risk Factors
Impaired glucose tolerance Japanese Americans Normal glucose tolerance Intra-abdominal fat Abdominal subcutaneous fat Observational study