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KMID : 0882419930440010001
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Korean Journal of Medicine
1993 Volume.44 No. 1 p.1 ~ p.18
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The Correlation between Insulin Resistance and the Pattern of Body Fat Distribution in Korean Patients with Non-insulin Dependent Diabetes Mellitus
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허갑범
이은직/김유리/임승길/안광진/정윤석/김경래/이현철/백인경
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Abstract
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ackground : The role of insulin resistance is known to be very important in the pathogenesis and clinical courses of human diseases such as diabetes mellitus, hypertension, atherosclerotic coronary vasclar disease, and
dyslipoproteinemia.
Methods : To investigate the correlation between insulin resistance and the pattern of body
fat distribution in korean patients with non-insulin dependent diabetes mellitus (NIDDM),
dietary survey, anthropometry, CT csan, measurement of body fat by body composition
analyzer, oral glucose tolerance test and measurement of glucose uptake rate by englycemic
hyperinsulinemic glucose clamp technique were performed in 6 normal weight patients and 12
overweight-obese NIDDM patients. Six of 12 overweight-obese patients are centrally obese with
waist to hip circumference ratio : WHR≥1 and 6 cases are peripherally obese with WHR〈1.
Results :
1) There was no difference between the mean body weight of centrally obese patients and
peripherally obese patients but WHR and body fat content of centrally obese patients were
significantly higher than those of peripherally obese patients.
2) In the centrally obese patients visceral fat area measured by CT scan was
significantly wider than in the peripherally obese patients but subcutaneous fat area was not
different between the two groups.
3) Plasma glucose levels on oral glucose tolerance tests were not different among the
three groups but plasma C-peptide and insulin levels at 2 hour after glucose load were
significantly higher in centrally obese patients than in peripherally obese patients.
4) Glucose uptake rate(M/I ratio) of centrally obese patients was significantly lower than that
of peripherally obese patients.
5) The WHR showd the highest negative correlation with m/I ratio in the all patients and
waist thigh circumference ratio (WTR) showed the hightest nagative correlation with M/I
ratio in overweight-obese patients.
6) Insulin area and fasting level of free fatty acid showed sighnificant positive
correlation with WHR and significant negative correlation with M/I ratio.
Conclustion : it could be concluded that the pattern of body fat distribution rather than the
relative body weight for hight or body fat content has a greater role in determining the
degree of insulin resistance in korean patients with niddm. And further a change of the body
onfiguration through adequate diet and exercise is ighly recommended for
overweight-obese NIDDM patients.
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KEYWORD
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