Visceral adiposity, fasting plasma insulin, and lipid and lipoprotein levels in Japanese Americans

OBJECTIVE: To examine the associations among visceral and subcutaneous adiposity, body-mass-index (BMI), fasting plasma insulin, lipid, and lipoprotein levels. DESIGN: Cross-sectional observational study. SUBJECTS: Non-diabetic second- (Nisei, n = 290) and third-generation (Sansei, n = 229) Japanese Americans. MEASUREMENTS: Intra-abdominal (IAF) and subcutaneous abdominal fat (SAF) area were measured using computed tomography. Easting plasma insulin, lipid, and lipoprotein levels were measured using standard methods. RESULTS: Higher fasting insulin was significantly related to greater mean IAF and SAF area, plasma triglycerides, total HDL and HDL(2) cholesterol in men and women of both generations. In a multiple linear regression analysis model among Nisei adjusted for gender, age, SAF, antihypertensive medication use, smoking, alcohol use, and exercise energy expenditure, IAF area and fasting insulin level were independently correlated with plasma triglycerides (IAF r = 0.22, fasting insulin r = 0.23), total HDL (IAF r = -0.29, fasting insulin r = -0.28), HDL(2) (IAF r = -0.30, fasting insulin r = -0.27), and HDL(3) cholesterol (IAF r = -0.19, fasting insulin r = -0.19). Among Sansei, similar associations were seen, except that fasting insulin was unrelated to total HDL or HDL(3) cholesterol. These effects differed by gender in several instances. CONCLUSIONS: Both visceral adiposity and fasting insulin level are significantly and independently related to adverse levels of lipids and lipoproteins in both generations of nondiabetic Japanese Americans. The association between adverse lipid profile and visceral obesity is not mediated solely through detrimental effects of intra-abdominal fat deposition on fasting insulin level.