Location of Body Fat Key
in Elderly's Diabetes Risk
Excerpt By Amy Norton, Reuters Health

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 the February 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, told Reuters Health.

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.

Reference Source 89

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