The Contribution of Cardiorespiratory Fitness and Visceral Fat to Risk Factors in Japanese Patients with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus

M. Nagano, Y. Kai, B. Zou, T. Hatayama, M. Suwa, H. Sasaki, Shuzo Kumagai

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

It is still unclear as to how cardiorespiratory fitness and visceral fat accumulation contribute to coronary heart disease (CHD) risk factors in patients with diabetes mellitus. The purpose of the present study was to investigate whether cardiorespiratory fitness contributes to such risk factors independently of visceral fat accumulation. Two hundred Japanese patients (137 men and 63 women, aged 22 to 81 years) with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (type 2 DM) without any intervention and pharmacological therapy participated in a cross-sectional study. The levels of fasting insulin, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and resting blood pressure were assessed. Maximal oxygen uptake (V̇o2max), an index of cardiorespiratory fitness, was predicted by a graded exercise test using a cycle ergometer. Visceral fat area (VFA) was measured by computed tomography scan. The criteria for abnormalities of the risk factors were determined according to the standard values for Japanese. All subjects were divided equally into the following 3 groups according to their fitness level: low-fit (V̇o2max < 32 mL/kg/min in men, V̇o2max < 26 mL/kg/min in women), mid-fit (32 ≤ V̇o2max < 36 in men, 26 ≤ V̇o 2max < 30 in women), and high-fit (V̇o2max ≥ 36 in men, V̇o2max ≥ 30 in women). The association between fitness level and the prevalence of abnormal values for these parameters was analyzed by a multiple logistic regression model adjusted for age and VFA. The odds ratio (OR) and 95% confidence interval (CI) for the prevalence of hyperinsulinemia were significantly lower in the mid-fit (OR = 0.35, 95% CI, 0.16 to 0.78) and in the high-fit groups (OR = 0.40, 95% CI, 0.16 to 0.98) compared with the low-fit group. In addition, ORs for the prevalence of low HDL-C in the mid-fit and high-fit groups were significantly lower (OR = 0.35, 95% CI, 0.14 to 0.86; and OR = 0.19; 95% CI, 0.08 to 0.60, respectively) than in the low-fit group. These results suggested that cardiorespiratory fitness might be one of the predictors of metabolic abnormalities, especially in patients with hyperinsulinemia and low HDL-C, independent of visceral fat accumulation in Japanese patients with IGT and type 2 DM.

Original languageEnglish
Pages (from-to)644-649
Number of pages6
JournalMetabolism: Clinical and Experimental
Volume53
Issue number5
DOIs
Publication statusPublished - May 2004

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Glucose Intolerance
Intra-Abdominal Fat
Type 2 Diabetes Mellitus
Odds Ratio
Confidence Intervals
HDL Cholesterol
Hyperinsulinism
LDL Cholesterol
Logistic Models
Exercise Test
Coronary Disease
Fasting
Diabetes Mellitus
Triglycerides
Cross-Sectional Studies
Cholesterol
Tomography
Cardiorespiratory Fitness
Pharmacology
Insulin

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

The Contribution of Cardiorespiratory Fitness and Visceral Fat to Risk Factors in Japanese Patients with Impaired Glucose Tolerance and Type 2 Diabetes Mellitus. / Nagano, M.; Kai, Y.; Zou, B.; Hatayama, T.; Suwa, M.; Sasaki, H.; Kumagai, Shuzo.

In: Metabolism: Clinical and Experimental, Vol. 53, No. 5, 05.2004, p. 644-649.

Research output: Contribution to journalArticle

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AB - It is still unclear as to how cardiorespiratory fitness and visceral fat accumulation contribute to coronary heart disease (CHD) risk factors in patients with diabetes mellitus. The purpose of the present study was to investigate whether cardiorespiratory fitness contributes to such risk factors independently of visceral fat accumulation. Two hundred Japanese patients (137 men and 63 women, aged 22 to 81 years) with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (type 2 DM) without any intervention and pharmacological therapy participated in a cross-sectional study. The levels of fasting insulin, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and resting blood pressure were assessed. Maximal oxygen uptake (V̇o2max), an index of cardiorespiratory fitness, was predicted by a graded exercise test using a cycle ergometer. Visceral fat area (VFA) was measured by computed tomography scan. The criteria for abnormalities of the risk factors were determined according to the standard values for Japanese. All subjects were divided equally into the following 3 groups according to their fitness level: low-fit (V̇o2max < 32 mL/kg/min in men, V̇o2max < 26 mL/kg/min in women), mid-fit (32 ≤ V̇o2max < 36 in men, 26 ≤ V̇o 2max < 30 in women), and high-fit (V̇o2max ≥ 36 in men, V̇o2max ≥ 30 in women). The association between fitness level and the prevalence of abnormal values for these parameters was analyzed by a multiple logistic regression model adjusted for age and VFA. The odds ratio (OR) and 95% confidence interval (CI) for the prevalence of hyperinsulinemia were significantly lower in the mid-fit (OR = 0.35, 95% CI, 0.16 to 0.78) and in the high-fit groups (OR = 0.40, 95% CI, 0.16 to 0.98) compared with the low-fit group. In addition, ORs for the prevalence of low HDL-C in the mid-fit and high-fit groups were significantly lower (OR = 0.35, 95% CI, 0.14 to 0.86; and OR = 0.19; 95% CI, 0.08 to 0.60, respectively) than in the low-fit group. These results suggested that cardiorespiratory fitness might be one of the predictors of metabolic abnormalities, especially in patients with hyperinsulinemia and low HDL-C, independent of visceral fat accumulation in Japanese patients with IGT and type 2 DM.

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