Hepatic and Skeletal Muscle Adiposity Are Associated with Diabetes Independent of Visceral Adiposity in Nonobese African-Caribbean Men

Iva Miljkovic, Allison L. Kuipers, Ryan K. Cvejkus, J. Jeffrey Carr, James G. Terry, Bharat Thyagarajan, Victor W. Wheeler, Sangeeta Nair, Joseph M. Zmuda

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Adipose tissue (AT) around and within non-AT organs (i.e., ectopic adiposity) is emerging as a strong risk factor for type 2 diabetes (T2D). Not known is whether major ectopic adiposity depots, such as hepatic, skeletal muscle, and pericardial adiposity (PAT), are associated with T2D independent of visceral adiposity (VAT). More data are particularly needed among high-risk nonobese minority populations, as the race/ethnic gap in T2D risk is greatest among nonobese. Methods: Thus, we measured several ectopic adiposity depots by computed tomography in 718 (mean age = 64 years) African-Caribbean men on the Island of Tobago overall, and stratified by obesity (obese N = 187 and nonobese N = 532). Results: In age, lifestyle risk factors, health status, lipid-lowering medication intake, body mass index and all other adiposity-adjusted regression analyses, and hepatic and skeletal muscle adiposity were associated with T2D among nonobese men only (all P < 0.05), despite no association between VAT and PAT and T2D. Conclusions: Our results support the "ectopic fat syndrome"theory in the pathogenesis of T2D among nonobese African-Caribbean men. Longitudinal studies are needed to clarify the independent role of ectopic adiposity in T2D, and to identify possible biological mechanisms underlying this relationship, particularly in high-risk African ancestry and other nonwhite populations.

Original languageEnglish (US)
Pages (from-to)275-283
Number of pages9
JournalMetabolic Syndrome and Related Disorders
Issue number6
StatePublished - Aug 2020

Bibliographical note

Funding Information:
This research was supported by grant R01-AR049747 (PI: J.M.Z.) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, and grants R03-DK092348 and R01-DK097084 (PI: I.M.) from the National Institute of Diabetes and Digestive and Kidney Diseases. A.L.K. was supported by grant K01-NL125658 from the National Heart, Lung, and Blood Institute.

Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc., publishers 2020.


  • African ancestry
  • ectopic fat
  • liver attenuation
  • myosteatosis
  • skeletal muscle attenuation
  • type 2 diabetes
  • visceral fat

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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