Visceral fat is a strong predictor of insulin resistance regardless of cardiorespiratory fitness in non-diabetic people

Abdominal adiposity and low cardiorespiratory fitness are assosicated with insulin resistance in people with impaired glucose tolerance and type 2 diabetes. However, little is known about which factor precedes insulin resistance in people with impaired glucose tolerance and type 2 diabetes, and which is the stronger predictor of insulin resistance in non-diabetic people. The purpose of this study was to examine the relationship between insulin resistance and cardiorespiratory fitness, visceral fat, and subcutaneous fat in non-diabetic people. Subjects included 87 men and 77 women aged 30-72 y (mean±SD, 51.3±12.3 y). Cardiorespiratory fitness was assessed by measuring the maximal oxygen uptake (VO_2max) in a progressive continuous test to exhaustion on a cycle ergometer. The visceral and subcutaneous fat areas were measured by magnetic resonance imaging. The homeostasis model assessment of insulin resistance (HOMA-R) was calculated from the fasting concentrations of glucose and insulin. Stepwise multiple linear regression analysis revealed that visceral and subcutaneous fat were significant correlates of HOMA-R, explaining 24% and 6% of the variance, respectively, whereas sex, age, and VO2max were not significant independent determinants. Abdominal fat deposition rather than cardiorespiratory fitness is a significant predictor of insulin resistance in non-diabetic people; visceral fat is the most important factor.