Body Fat Patterning, Hepatic Fat and Pancreatic Volume of Non-Obese Asian Indians with Type 2 Diabetes in North India: A Case-Control Study

<div><p>Objective</p><p>To evaluate body fat patterning and phenotype including hepatic fat and pancreatic volume of non-obese (BMI: < 25 kg/m²) Asian Indians with type 2 diabetes residing in North India.</p><p>Methods</p><p>Non-obese patients with type 2 diabetes (<i>n</i> = 93) and non-obese, normo-glycemic subjects (<i>n</i> = 40) were recruited. BMI, waist & hip circumferences, skinfold thickness at 8 sites, body fat, lean mass and detailed abdominal fat evaluation [total abdominal fat, total subcutaneous fat (superficial, deep, anterior, and posterior), total intra-abdominal fat (intra-peritoneal, retroperitoneal)], liver span, grades of fatty liver and pancreatic volume were compared.</p><p>Results</p><p>Waist circumference, subscapular skinfolds and total truncal fat (on DEXA) were higher whereas calf, total peripheral skinfolds and total leg fat (on DEXA) lower in patients. Specifically, the following volumes were higher in cases as compared to controls; total abdominal fat (19.4%), total intra-abdominal fat (49.7%), intra-peritoneal fat (47.7%), retroperitoneal fat (70.7%), pancreatic volume (26.6%), pancreatic volume index (21.3%) and liver span (10.8%). In cases, significant positive correlations were observed for pancreatic volume with BMI, waist and hip circumferences, W-HR, subscapular, abdominal and total truncal skinfolds, truncal, total subcutaneous, total intra-abdominal, intra-peritoneal, retroperitoneal fat depots, liver span and fatty liver.</p><p>Conclusions</p><p>In non-obese Asian Indians with type 2 diabetes, subcutaneous and intra-abdominal obesity, including fatty liver, and pancreatic volume were higher and peripheral subcutaneous adiposity was lower than BMI matched non-diabetic subjects. Importantly, increased pancreatic volume in patients was highly correlated with multiple measures of abdominal obesity and liver fat.</p></div

Abdominal fat depots, pancreatic volume & liver span measured by MRI (1.5 Tesla) in cases (<i>n</i> = 93, shown in black bars) & controls (<i>n</i> = 40, shown in box filled with crossed lines).

<p>Abdominal fat depots, pancreatic volume & liver span measured by MRI (1.5 Tesla) in cases (<i>n</i> = 93, shown in black bars) & controls (<i>n</i> = 40, shown in box filled with crossed lines).</p

Skinfold measurements in cases (<i>n</i> = 93, shown in black bars) <i>vs</i>. controls (<i>n</i> = 40, shown in bars filled with crossed lines).

<p>Skinfold measurements in cases (<i>n</i> = 93, shown in black bars) <i>vs</i>. controls (<i>n</i> = 40, shown in bars filled with crossed lines).</p

Abdominal fat depots and pancreatic volume in a 33 year old non-obese patient with type 2 diabetes, quantified from image obtained using MRI (1.5 Tesla) at L2/L3 region of lumbar vertebrae (A): Superficial abdominal subcutaneous fat, (B): Deep abdominal subcutaneous fat, (C): Anterior abdominal subcutaneous fat, (D): Posterior abdominal subcutaneous fat, (E): Intra-peritoneal fat, (F): Retroperitoneal fat & (G): Pancreatic volume.

<p>Abdominal fat depots and pancreatic volume in a 33 year old non-obese patient with type 2 diabetes, quantified from image obtained using MRI (1.5 Tesla) at L2/L3 region of lumbar vertebrae (A): Superficial abdominal subcutaneous fat, (B): Deep abdominal subcutaneous fat, (C): Anterior abdominal subcutaneous fat, (D): Posterior abdominal subcutaneous fat, (E): Intra-peritoneal fat, (F): Retroperitoneal fat & (G): Pancreatic volume.</p

Correlations of anthropometry, body composition, abdominal fat compartments and liver span with pancreatic volume.

<p>* <i>p</i>< 0.05: Statistically significant.</p><p>*Total peripheral skinfolds = Sum of biceps, triceps, thigh & calf skinfolds,</p><p>*Total truncal skinfolds = Sum of sub scapular, suprailiac (horizontal & vertical) & abdominal skinfolds (diagonal & vertical).</p><p>^#Average abdominal skinfolds = Mean of abdominal skinfolds (vertical+ horizontal).</p><p>^ǂ Measured by Dual energy X ray absorptiometry.(see text for details).</p><p>^<b>€</b> Measured by MRI (1.5 Tesla) at L2/L3 region of the lumbar vertebrae (see text for details).</p><p>Correlations of anthropometry, body composition, abdominal fat compartments and liver span with pancreatic volume.</p