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

Abstract

Context: Intermuscular adipose tissue (IMAT) at different anatomical locations may exert distinct effects on cardiometabolic risk. Objective: The present study investigated the relationships of abdominal and mid-thigh IMAT with glucose homeostasis and cardiometabolic risk in adults with overweight or obesity. Design: Multicenter cross-sectional study. Setting: Outpatient clinic. Participants: 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). Main Outcome Measures: 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. Results: 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). Conclusion: 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.