The ratio of pericardial to subcutaneous adipose tissues is associated with insulin resistance

OBJECTIVE: To examine the association between pericardial adipose tissue (PAT) and the ratio of PAT to subcutaneous adipose tissue (SAT) with insulin resistance in adults with and without type 1 diabetes (T1D). METHODS: Data for this report came from a substudy of the Coronary Artery Calcification in Type 1 Diabetes cohort (n=83; 38 with T1D, 45 without T1D). Insulin resistance was measured by hyperinsulinemic-euglycemic clamp. Abdominal computed tomography (CT) was used to measure visceral adipose tissue (VAT) and SAT. PAT was measured from CT scans of the heart. RESULTS: PAT and the ratio of PAT to SAT was higher in males compared to females. After adjustment for demographics, diabetes, blood pressure and lipid factors, BMI, VAT and log PAT/SAT ratio, log PAT was positively associated with the glucose infusion rate (GIR) in females only (β=3.36 ±1.96, p=0.097, p for sex interaction=0.055). Conversely, the log PAT/SAT ratio was significantly associated with decreased GIR in both males and females (β=−2.08 ±1.03, p=0.047, p for sex interaction=0.768). CONCLUSIONS: In conclusion, we found a significant association between the PAT/SAT ratio and insulin resistance, independent of BMI, VAT and PAT. These results highlight the importance of considering fat distribution independent of volume.