J Korean Soc Endocrinol.  2005 Oct;20(5):452-459. 10.3803/jkes.2005.20.5.452.

Role of Thigh Muscle in the Carotid artery Intima-Media Thickness and Insulin resistance

• Hwang LJ
• Park KS
• Chae YT
• Shi KD
• Kim SK
• Park SW
• Kim YL
• Cho YW
• Choi YK
• Lee SJ

• KMID: 2200592
• DOI: http://doi.org/10.3803/jkes.2005.20.5.452

Abstract

BACKGROUND: There have been recent reports that the fat distribution within skeletal muscle and the amount of muscle mass are associated with insulin resistance and the development of type 2 diabetes mellitus (T2DM). This study evaluated the impacts of visceral fat and thigh muscle from patients with T2DM and healthy subjects on atherosclerosis and insulin resistance.
METHODS
Forty-two patients with newly-developed T2DM and 11 healthy subjects were selected for the study. The diabetic patients were subdivided into two groups, those under 40 years of age, as the young T2DM (n=21) group, and 40 years-old or greater, as the old T2DM (n=21) group. CT scans were obtained for all patients at the L4-L5 level and at the mid-portion between the greater trochanter and upper margin patella. The carotid intima-media thickness (IMT) was also measured using high resolution B-mode ultrasonography.
RESULTS
The mean visceral fat area (VFA) in the old T2DM group was 169.4+/-13.2cm2, which was significantly greater than that found in the healthy subjects (67.9+/-7.92cm2, P<0.001) and young T2DM group (127.1+/-10.4cm2, P<0.05). The mean visceral fat to normal density muscle area ratio (VMNR) in the old T2DM group was 1.50+/-0.19, which was greater than in the healthy subjects (0.46+/-0.52, P<0.001) and young T2DM group (1.01+/-0.10, P<0.05). The total thigh muscle areas in the young and old T2DM groups were smaller than that in the healthy subjects, but without statistical significance. VMNR showed a positive correlation with the IMT and HOMA-IR. However, the total thigh muscle area was negatively correlated with the IMT. The normal density muscle area also showed significant negative correlations with the IMT and HOMA-IR. In a multiple regression analysis, age and VMNR were the most important independent risk factors of an increased carotid IMT.
CONCLUSION
This study showed that the role of thigh muscle, as well as that of visceral fat, played a very important role in the occurrence of atherosclerosis. VMNR was found to be an especially important independent factor for an increased carotid IMT.

MeSH Terms

Adult
Atherosclerosis
Carotid Arteries*
Carotid Intima-Media Thickness
Diabetes Mellitus, Type 2
Femur
Humans
Insulin Resistance*
Insulin*
Intra-Abdominal Fat
Muscle, Skeletal
Patella
Risk Factors
Thigh*
Tomography, X-Ray Computed
Ultrasonography
Insulin

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