The Concept of CMR
Abdominal Obesity and Type 2 Diabetes
- 1Key Points (1 page)
- 2The “Diabesity” Epidemic (1 page)
- 3Beyond Excess Body Weight (1 page)
- 4Abdominal Obesity: the Diabetogenic Obesity (3 pages)
- 5Upper Body Fat Distribution: the Importance of Intra-abdominal Adipose Tissue (2 pages)
- 6References (1 page)
Beyond Excess Body Weight
The strong relationship between obesity and type 2 diabetes does not mean that being overweight or obese will inevitably cause type 2 diabetes. For example, some normal weight individuals may be at high risk of developing type 2 diabetes, whereas many very obese individuals are not insulin resistant (11) and may never develop the disease. Some etiological factors linking excess body fat and type 2 diabetes could explain this phenomenon. Obesity and type 2 diabetes share a number of causative lifestyle factors such as excessive energy intake, a diet high in saturated fat, and a sedentary lifestyle. However, the risk of developing type 2 diabetes may also depend on genetic susceptibility and the distribution of adipose tissue (12).
The possibility of a relationship between body fat distribution and type 2 diabetes was first raised in the mid-forties by French physician Jean Vague (13). He reported that the complications generally found in obese patients depended more on the location of the excess fat rather than obesity per se (13). Following this observation, he described the high-risk form of obesity as “android obesity,” a condition commonly found in men and in which adipose tissue accumulates in the trunk. In opposition, he described the accumulation of body fat in the gluteo-femoral region—the common fat pattern of premenopausal women—as “gynoid obesity.” This type of fat distribution rarely leads to common obesity-related complications (14, 15). Since these pioneering observations, many cross-sectional and prospective studies have linked type 2 diabetes to body fat distribution.