Abdominal adiposity is a stronger predictor of insulin resistance than fitness among 50-95 year olds

Diabetes Care
Susan B RacetteJohn O Holloszy

Abstract

Physical inactivity and increased adiposity contribute to insulin resistance; less is known, however, about the relative contributions of these factors in older adults. The aim of this study was to determine whether cardiovascular fitness, whole-body adiposity, or abdominal adiposity is the strongest predictor of insulin resistance into old age. Subjects included 407 men and women aged 50-95 years (means +/- SD 69 +/- 11 years). Insulin resistance was estimated using the insulin sensitivity index (ISI) of Matsuda and DeFronzo [ISI = 10,000/square root of (fasting glucose x fasting insulin) x (mean glucose x mean insulin during an oral glucose tolerance test); lower ISI = greater insulin resistance]. Fitness was determined with a treadmill maximal oxygen consumption (Vo(2max)) test. Whole-body adiposity measures included BMI and percent fat by dual-energy X-ray absorptiometry or hydrodensitometry; abdominal adiposity was estimated by waist circumference. Waist circumference was the strongest independent correlate of ISI (r = -0.52, P < 0.0001), explaining 28% of the variance when controlling for sex, BMI, percent fat, and Vo(2max). BMI (r = -0.45), percent fat (r = -0.40), and Vo(2max) (r = 0.22) independently predicted ISI (all...Continue Reading

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