Impact of Abdominal and Thigh Intermuscular Adipose Tissue on Glucose and Cardiometabolic Risk in Adults With Obesity.

Abstract

Intermuscular adipose tissue (IMAT) at different anatomical locations may exert distinct effects on cardiometabolic risk. The present study investigated the relationships of abdominal and mid-thigh IMAT with glucose homeostasis and cardiometabolic risk in adults with overweight or obesity. Multicenter cross-sectional study. Outpatient clinic. One hundred eighty-nine adults (50% women; age: 46.8 ± 6.3 years) with overweight or obesity (body mass index: 32.9 ± 3.5 kg/m2). IMAT content in abdominal and mid-thigh regions was measured by magnetic resonance imaging. Mean glucose levels were monitored over 24 hours during 14 days using continuous glucose monitoring devices. We computed a cardiometabolic risk score including fasting high-density lipoprotein cholesterol, triglycerides, glucose, waist circumference, and systolic and diastolic blood pressure. No associations were identified between abdominal IMAT and glucose homeostasis or cardiometabolic risk (all P > .05). In contrast, a positive association of mid-thigh IMAT with 24-hour (β = 0.226; P = .007), diurnal (β = 0.224; P = .008), and nocturnal mean glucose levels (β = 0.233; P = .006) as well as with cardiometabolic risk score (β = 0.324; P < .001) was observed. Participants with greater accumulation of IMAT in the mid-thigh compared to the abdominal region exhibited significantly higher mean glucose levels and cardiometabolic risk (all P < .005). These findings emphasize the importance of distinguishing between adipose tissue depots when evaluating cardiometabolic risk, as specific accumulation patterns-particularly in the mid-thigh region-may significantly influence individual risk profiles.