ackground : Although Koreans are generally leaner than people in America, they have a
tendency to central adipose tissue distribution. Central obesity with visceral fat accumulation,
measured by computed tomogtraphy, can cause metabolic complications. We determined the
relation between obesity and glucose metabolism in 55 Korean middle-aged women.
Methods : Anthropometric parameters and visceral and subcutaneous fat areas at the
umbilical level were determined as indices of obesity. Nutrient intake, serum levels of lipids
and response areas of glucose, C-peptide, insulin, and free fatty acid (FFA) during oral
glucose tolerance test were determined.
Results : Visceral fat area correlated the most significantly with biochemical parameters
among obese indices. The triglyceride level and the response areas of FFA, glucose, insulin
and C-peptide were all higher in the group of visceral-type obesity (n=20, visceral fat area >
10000 mm^2), than in the group of subcutaneoustype obesity (n=18, visceral fat area <7400
mm^2), though percent ideal body weight was not different between two groups. Thirty five
percents in the group of visceral-type obesity showed impaired glucose tolerance (IGT) and
non-insulin-dependent diabetes mellitus (NIDDM). Body weight, subcutaneous fat area and
the response areas of insulin and C-peptide were lower and the response areas of Ffa and
glucose were higher in viceral-type obese patients with IGT and NIDDM than in
visceral-type obese subjects with normal glucose tolerance.
Conclusion : Our results indicate that increased visceral fat area can be associated with
the development of NIDDM because of the severe insulin resistance, even when small amount
of insulin recretion is decreased. Increased calorie intake and decreased physical activity
could partly explain visceral fat accumulation in the intraabdominal cavity.
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