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Location
of Body Fat Key in Elderly's Diabetes Risk
Although obesity is closely tied to type 2 diabetes, normal-weight
older adults may face an increased risk when they have excess
fat in all the wrong places, new research shows.
The study found that greater fat in the gut or within the
muscle tissue of the thighs was related to diabetes risk
among normal-weight men and women in their 70s.
Obese individuals were also at a greater diabetes risk,
but obesity was clearly not "requisite" for study
participants to develop the disease, according to the authors.
In fact, about one third of men and less than half of women
with type 2 diabetes were obese, they report in an issue
of the journal Diabetes Care.
"Just because an older person is not overweight or
obese does not necessarily mean that they are not at risk
for diabetes," Dr. Bret H. Goodpaster, the study's
lead author stated.
Normal-weight older people can still have excess body fat,
and "where they put the fat is an important factor
in their risk for this disease," said Goodpaster, of
the University of Pittsburgh Medical Center in Pennsylvania.
Type 2 diabetes arises when the body becomes resistant to
insulin, a hormone that after meals helps shuttle sugar
from the blood and into cells to be used for energy. It
is closely associated with obesity, but other risk factors
such as family history and older age also contribute to
the disorder.
While the association between obesity and type 2 diabetes
among young and middle-aged people has "undisputed
strength," the link has seemed less strong among the
elderly, Goodpaster and his colleagues note.
For one, type 2 diabetes remains most common among the elderly,
although their rate of obesity is lower than that of middle-aged
adults.
According to the study authors, their findings support the
hypothesis that a person can be "metabolically obese,"
despite a normal weight. This theory holds that body-fat
distribution is a key factor in whether a person develops
insulin resistance and abnormal blood sugar levels.
In this study, of nearly 3,000 men and women, those with
either type 2 diabetes or impaired glucose tolerance--a
prediabetic condition--had greater amounts of fat deep in
the abdomen or interspersed throughout the thigh muscles
than those with normal glucose tolerance.
These regional fat deposits were associated with insulin
resistance among normal-weight, but not obese, men and women.
On the brighter side, Goodpaster noted that exercise has
been found to be particularly effective at cutting abdominal
fat.
He said his team is now studying whether exercise and weight
loss can similarly reduce fat within muscular tissue in
older adults.
SOURCE: Diabetes Care 2003;26:372-379.
Article Source: Reuters Health
Article Author: Amy Norton
Net Reference 89
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