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Objective: Both Visceral (VAT) and subcutaneous abdominal fat (SAT) have been linked to
systemic inflammation in non-diabetic cohorts. We examined the relationships between VAT
and SAT, and systemic inflammatory markers in a large well-characterized cohort with type 2
diabetes.
Research Design and Methods: Three hundred eighty two subjects with type 2 diabetes in the
CHICAGO cohort underwent abdominal computed tomography to determine SAT and VAT
distribution. Fasting blood was obtained for measurement of inflammatory markers. The
relationships between inflammatory markers and BMI, SAT and VAT were examined using
regression models adjusted for age, sex, diabetes treatment, duration of diabetes, smoking, statin
use and hemoglobin A1c.
Results: VAT was positively related to CRP, MCP, ICAM-1 and PAI-1 antigen before
adjustment for BMI. After adjustment for BMI, the relationship to CRP was lost but positive
associations with MCP (P<0.01), PAI-1 (P<0.0001), ICAM-1 (P<0.01) and VCAM (P=0.01)
were evident. BMI was positively related to CRP (P<0.0001) and IL-6 (P<0.01) even after
adjustment for VAT and SAT. SAT was not related to any inflammatory marker after
adjustment for BMI.
Conclusions: In this large group of subjects with type 2 diabetes, BMI was most strongly
associated with CRP and LL-6 levels. SAT was not associated with markers of systemic
inflammation. The size of the VAT depot provided information additional to that provided by
BMI regarding inflammatory markers that are strongly related to vascular wall remodeling and
coagulation. Our findings suggest that adipose tissue distribution remains an important
determinant of systemic inflammation in type 2 diabetes.
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