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Dietary patterns and risk of type 2 diabetes: the multi-ethnic cohort
abstract
cause lipolysis but not lipogenesis in mature fat cells, thus resulting in smaller, more metabolically active adipocytes. These findings suggest that chronic exposure to GCs in vivo would promote an increase in fat cell number but these adipocytes would be more metabolically active, resulting in an overall increase in circulating free fatty acids. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest P-1559 Extramyocellular adipose tissue in type 2 diabetes L. Luu1, J. Crilly2, B. Newcomer3, W. Cefalu1 LSU-Pennington Biomedical Research Center, Nutrition and Chronic Diseases, Baton Rouge, USA 2 University of Rochester, Psychiatry, Rochester, USA 3 University of Alabama at Birmingham, School of Health Professionals, Birmingham, USA
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aims: Ectopic fat depositions in skeletal muscle, i.e. intermuscular adipose tissue and intramyocellular lipids, are associated with insulin resistance and diabetes. However, extramyocellular adipose tissue (EMAT), defined as the adipose tissue (AT) between muscle fibers, has not been investigated. We sought to examine EMAT distribution in subjects with Type 2 diabetes (T2D) and evaluate possible differences as a function of gender and race. In addition, we assessed associations of EMAT with measures of adiposity, inflammation, and insulin sensitivity (IS). Methods: EMAT was assessed by proton magnetic resonance spectroscopy in the tibialis anterior muscle (EMATTA, n=71), soleus (EMATSol, n=70), and gastrocnemius (EMATGa, n=50) in subjects with T2D [Ages 56.5±8 (mean±SD) and BMI of 31.7±5 kg/m2]. Internal water reference was used to normalize all EMAT results. Adiposity measures were performed using DXA for total body fat (FM) and crosssectional CT scans for visceral AT volume (VAT), deep subcutaneous AT volume (DSAT), and subcutaneous AT volume (SAT). Serum chemistries were analyzed for inflammatory markers. IS was assessed by hyperinsulinemic-euglycemic clamps. Subcutaneous abdominal biopsies were obtained and evaluated for mean fat cell size (MFCS) at the baseline of the clamp. results: Female subjects had increased EMATTA compared to male subjects (0.0149±0.01 vs. 0.009±0.01, arbitrary scanning units (ASU), p=0.02). No other gender or race differences were noted. However, EMATTA was positively associated with FM (r=0.323, p=0.02). EMATSol was directly correlated to hs-CRP (r=0.360, p=0.02), TNF-a (r=0.339, p=0.03), and IS (r= -32, p=0.05). EMATGa was associated with FM (r=0.486, p=0.001), VAT (r=0.250, p=0.08), and MFCS (r=0.459, p=0.001). In an age-FM adjusted cohort (n=51), increased EMATTA in female subjects remained when compared to male subjects (0.0171±0.01 vs. 0.009±0.01, ASU, p=0.003). African-Americans showed a trend toward higher EMATSol compared to Caucasian (0.025±0.02 vs. 0.016±0.01, ASU, p=071). No other differences were observed. EMATTA was positively correlated with FM (r=0.354, p=0.02) and TNFa (r=0.403, p=0.03). EMATSol showed direct association to TNFa (r=0.403, p=0.03). EMATGa showed positive correlation to FM (r=0.369, p=0.04), DSAT (r=0.396, p=0.02), and MFCS (r=0.428, p=0.01). Discussion: We present novel observations of EMAT in Type 2 diabetes subjects. We demonstrate gender differences in EMATTA distribution. A robust pattern emerged showing strong associations between EMATTA and EMATSol to inflammatory markers and insulin sensitivity, while EMATGa consistently displayed direct associations to measures of adiposity. EMAT is a novel ectopic adipose depot that may offer insights into the cross-communication network between AT and skeletal muscle. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest
P-1560 Dietary patterns and risk of type 2 diabetes: the multi-ethnic cohort G. Maskarinec1, E. Erber1, A. Grandinetti2, S.Y. Park1, B.N. Hopping1, L.N. Kolonel1 1 University of Hawaii, Cancer Research Center, Honolulu, USA 2 University of Hawaii, John A. Burns School of Medicine, Honolulu, USA aims: It is well known that excess energy intake and overweight/ obesity are risk factors for the development of type 2 diabetes. Our goal was to find out if the type and composition of the regular diet also influences diabetes risk. Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes risk associated with different nutritional patterns. Methods: After excluding subjects with other ethnicity, invalid diet, and missing values, 75,512 Caucasians, Japanese Americans, and Native Hawaiians were included in this analysis. Of these, 8,587 were incident diabetes cases which had been identified through questionnaires and linkages with the two major health plans in Hawaii. All subjects completed a validated food frequency questionnaire. Three previously identified dietary patterns, “Vegetables”, “Milk and Fruits”, and “Fat and Meat”, and food groups were analyzed in relation to diabetes incidence using Cox proportional hazards models. We estimated hazard ratios (HR) and 95% confidence intervals (CI) while adjusting for age, ethnicity, education, body mass index (BMI), physical activity, and total energy intake. results: Diabetes cases were more likely to be Japanese American or Native Hawaiian than the non-cases and tended to have lower education and higher BMI. Native Hawaiians were more likely to have high scores for the “Fat and Meat” and “Vegetables” patterns, while Japanese Americans showed a stronger association with the “Vegetables” and Caucasians with the “Fruit and Milk” pattern. “Fat and Meat” was associated with a 50% higher diabetes risk among men when the highest quintile was compared to the lowest (ptrend <0.0001). In women, the risk was approximately 20% higher (ptrend = 0.01) for women in the highest quintile. The associations for the “Fat and Meat” pattern were consistent across ethnic groups. The “Vegetables” pattern was weakly protective against diabetes among men, but the trend test was only significant for Caucasians and Japanese Americans. In women, the “Vegetables” pattern did not lower diabetes risk in any of the three ethnic groups. On the other hand, the “Milk and Fruits” pattern was associated with a lower diabetes risk among women with fairly consistent risk estimates across ethnic groups, while a protective effect in men was restricted to Caucasians. When we examined individual food groups, the results were in agreement with the dietary patterns. In particular, a strong association with red meat was seen among all ethnic groups. conclusions: These findings within a multiethnic population indicate that food intake as described by dietary patterns is strongly associated with diabetes risk. Therefore, recommending diets low in meat and rich in vegetables and fruits may be protective against type 2 diabetes independent of weight control. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest P-1562 Effects of native banana resistant starch on body weight and insulin resistance in non-diabetic obese women J. Ble1, M.A. Aparicio-Trapala2, M.-C. Cervantes-Toache3, A. RodriguezHernandez4, R.L. Martinez-Bricaire3, R. Cordova-Uscanga3, I.E. Juarez-
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cause lipolysis but not lipogenesis in mature fat cells, thus resulting in smaller, more metabolically active adipocytes. These findings suggest that chronic exposure to GCs in vivo would promote an increase in fat cell number but these adipocytes would be more metabolically active, resulting in an overall increase in circulating free fatty acids. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest P-1559 Extramyocellular adipose tissue in type 2 diabetes L. Luu1, J. Crilly2, B. Newcomer3, W. Cefalu1 LSU-Pennington Biomedical Research Center, Nutrition and Chronic Diseases, Baton Rouge, USA 2 University of Rochester, Psychiatry, Rochester, USA 3 University of Alabama at Birmingham, School of Health Professionals, Birmingham, USA
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aims: Ectopic fat depositions in skeletal muscle, i.e. intermuscular adipose tissue and intramyocellular lipids, are associated with insulin resistance and diabetes. However, extramyocellular adipose tissue (EMAT), defined as the adipose tissue (AT) between muscle fibers, has not been investigated. We sought to examine EMAT distribution in subjects with Type 2 diabetes (T2D) and evaluate possible differences as a function of gender and race. In addition, we assessed associations of EMAT with measures of adiposity, inflammation, and insulin sensitivity (IS). Methods: EMAT was assessed by proton magnetic resonance spectroscopy in the tibialis anterior muscle (EMATTA, n=71), soleus (EMATSol, n=70), and gastrocnemius (EMATGa, n=50) in subjects with T2D [Ages 56.5±8 (mean±SD) and BMI of 31.7±5 kg/m2]. Internal water reference was used to normalize all EMAT results. Adiposity measures were performed using DXA for total body fat (FM) and crosssectional CT scans for visceral AT volume (VAT), deep subcutaneous AT volume (DSAT), and subcutaneous AT volume (SAT). Serum chemistries were analyzed for inflammatory markers. IS was assessed by hyperinsulinemic-euglycemic clamps. Subcutaneous abdominal biopsies were obtained and evaluated for mean fat cell size (MFCS) at the baseline of the clamp. results: Female subjects had increased EMATTA compared to male subjects (0.0149±0.01 vs. 0.009±0.01, arbitrary scanning units (ASU), p=0.02). No other gender or race differences were noted. However, EMATTA was positively associated with FM (r=0.323, p=0.02). EMATSol was directly correlated to hs-CRP (r=0.360, p=0.02), TNF-a (r=0.339, p=0.03), and IS (r= -32, p=0.05). EMATGa was associated with FM (r=0.486, p=0.001), VAT (r=0.250, p=0.08), and MFCS (r=0.459, p=0.001). In an age-FM adjusted cohort (n=51), increased EMATTA in female subjects remained when compared to male subjects (0.0171±0.01 vs. 0.009±0.01, ASU, p=0.003). African-Americans showed a trend toward higher EMATSol compared to Caucasian (0.025±0.02 vs. 0.016±0.01, ASU, p=071). No other differences were observed. EMATTA was positively correlated with FM (r=0.354, p=0.02) and TNFa (r=0.403, p=0.03). EMATSol showed direct association to TNFa (r=0.403, p=0.03). EMATGa showed positive correlation to FM (r=0.369, p=0.04), DSAT (r=0.396, p=0.02), and MFCS (r=0.428, p=0.01). Discussion: We present novel observations of EMAT in Type 2 diabetes subjects. We demonstrate gender differences in EMATTA distribution. A robust pattern emerged showing strong associations between EMATTA and EMATSol to inflammatory markers and insulin sensitivity, while EMATGa consistently displayed direct associations to measures of adiposity. EMAT is a novel ectopic adipose depot that may offer insights into the cross-communication network between AT and skeletal muscle. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest
P-1560 Dietary patterns and risk of type 2 diabetes: the multi-ethnic cohort G. Maskarinec1, E. Erber1, A. Grandinetti2, S.Y. Park1, B.N. Hopping1, L.N. Kolonel1 1 University of Hawaii, Cancer Research Center, Honolulu, USA 2 University of Hawaii, John A. Burns School of Medicine, Honolulu, USA aims: It is well known that excess energy intake and overweight/ obesity are risk factors for the development of type 2 diabetes. Our goal was to find out if the type and composition of the regular diet also influences diabetes risk. Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes risk associated with different nutritional patterns. Methods: After excluding subjects with other ethnicity, invalid diet, and missing values, 75,512 Caucasians, Japanese Americans, and Native Hawaiians were included in this analysis. Of these, 8,587 were incident diabetes cases which had been identified through questionnaires and linkages with the two major health plans in Hawaii. All subjects completed a validated food frequency questionnaire. Three previously identified dietary patterns, “Vegetables”, “Milk and Fruits”, and “Fat and Meat”, and food groups were analyzed in relation to diabetes incidence using Cox proportional hazards models. We estimated hazard ratios (HR) and 95% confidence intervals (CI) while adjusting for age, ethnicity, education, body mass index (BMI), physical activity, and total energy intake. results: Diabetes cases were more likely to be Japanese American or Native Hawaiian than the non-cases and tended to have lower education and higher BMI. Native Hawaiians were more likely to have high scores for the “Fat and Meat” and “Vegetables” patterns, while Japanese Americans showed a stronger association with the “Vegetables” and Caucasians with the “Fruit and Milk” pattern. “Fat and Meat” was associated with a 50% higher diabetes risk among men when the highest quintile was compared to the lowest (ptrend <0.0001). In women, the risk was approximately 20% higher (ptrend = 0.01) for women in the highest quintile. The associations for the “Fat and Meat” pattern were consistent across ethnic groups. The “Vegetables” pattern was weakly protective against diabetes among men, but the trend test was only significant for Caucasians and Japanese Americans. In women, the “Vegetables” pattern did not lower diabetes risk in any of the three ethnic groups. On the other hand, the “Milk and Fruits” pattern was associated with a lower diabetes risk among women with fairly consistent risk estimates across ethnic groups, while a protective effect in men was restricted to Caucasians. When we examined individual food groups, the results were in agreement with the dietary patterns. In particular, a strong association with red meat was seen among all ethnic groups. conclusions: These findings within a multiethnic population indicate that food intake as described by dietary patterns is strongly associated with diabetes risk. Therefore, recommending diets low in meat and rich in vegetables and fruits may be protective against type 2 diabetes independent of weight control. Obesity: weight regulation, prevention, management, pathophysiology No conflict of interest P-1562 Effects of native banana resistant starch on body weight and insulin resistance in non-diabetic obese women J. Ble1, M.A. Aparicio-Trapala2, M.-C. Cervantes-Toache3, A. RodriguezHernandez4, R.L. Martinez-Bricaire3, R. Cordova-Uscanga3, I.E. Juarez-
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