Change in CT-measured abdominal subcutaneous and visceral but not thigh fat areas predict future insulin sensitivity

Aims: We examined the longitudinal association between change in body composition directly measured by computed tomography (CT) and future insulin sensitivity. Methods: This was a prospective study with 10 years of follow-up with 297 JapaneseAmerican without diabetes. Intra-abdominal fat area (IAFA) and abdominal subcutaneous fat area (SCFA), and thigh SCFA were measured by CT. Insulin sensitivity was calculated by HOMA-IR and the Matsuda index. Results: Baseline and change in IAFA were significantly and independently associated with change in HOMA-IR and Matsuda index during follow-up. In multivariate analysis, IAFA and 10-year change in IAFA (D IAFA) was significantly and positively associated with 10year HOMA-IR (p < 0.001) and significantly and negatively associated with 10-year Matsuda index (p < 0.001). The association with Matsuda index though was non-linear and best modeled as a quadratic function (D IAFA + D IAFA2). No significant associations in multivariate analyses were seen between thigh SCFA and insulin sensitivity or abdominal SCFA and HOMA-IR but an increase in abdominal SCFA was associated with diminished insulin sensitivity measured by the Matsuda index. Conclusions: An increase in visceral adiposity predicts diminished insulin sensitivity over 10 years of follow-up independent of the size of this adipose depot at baseline. (C) 2019 Elsevier B.V. All rights reserved.