Obesity, Abdominal Obesity, and Insulin Resistance

The correlation of body mass index (BMI) with both adiposity and risk for type 2 diabetes mellitus (DM) is positive. An elevated BMI is also associated with increased mortality from cardiovascular disease (CVD). However, for any given BMI measurement, some persons are at risk for type 2 DM and CVD, while others are not. This disparity of risk may relate to differences in age, fitness, and body composition, including body fat. Obesity— excess body fat— is associated with insulin resistance. Abdominal obesity, in particular, places people at higher risk for developing insulin resistance and, consequently, is associated with an increased risk for type 2 DM and CVD. The association between obesity and insulin resistance is largely due to changes in the function of adipose tissue, specifically, increased release of free fatty acids and abnormalities in adipokine secretion. The properties of visceral adipose tissue may cause these dysfunctions to become magnified. Weight loss has the potential to improve insulin sensitivity through alterations in adipose tissue function.