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Ectopic Fat and Risk of Diabetes

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Dr Shehla Shaikh, Mumbai    26 November 2018

  1. Ectopic fat may be defined as the accumulation of TG in non-adipose lean tissues having no capacity for fat storage, resulting in organelle, cellular and organ dysfunction.
  2. Ectopic fat deposition, rather than the whole body fat distribution, causes insulin resistance and vascular failure. Excess FFA influences insulin secretion and b-cell function.
  3. Obesity is strongly associated with NAFLD. Ectopic fat accumulation in the liver is both the cause and effect of insulin resistance. There is increasing evidence of an association between PCOS and ectopic fat.
  4. A study assessed the contribution of visceral adipose tissue (VAT), hepatic fat fraction (HFF), and pancreatic fat fraction (PFF) to prediabetes in overweight/obese African American (AA) and Latino youth. Ectopic fat in pancreatic and hepatic depots was higher in minority adolescents with prediabetes when compared to those without prediabetes, independent of total body fat and visceral adiposity. Even a relatively small amount of increased hepatic fat was associated with prediabetes.
  5. Determinants of ectopic fat accumulation – Genetic susceptibility; genetic-epigenetic interface and low SAT capacity; maternal nutrition; lifestyle factors; dietary patterns; activity patterns.
  6. Ectopic fat could be the new target for obesity treatment. It is very responsive to weight loss. Hypocaloric, fat-restricted diet causing 8% weight loss is associated with reduction in liver fat by 40-80%.

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