Regional obesity and NIDDM.

Obesity and NIDDM are clearly linked. The subgroup of abdominal, visceral obesity has been shown to have a particularly close link to the development of diabetes. This is probably due to the marked insulin resistance of that condition. Epidemiological data show a predictive power for the development of NIDDM in both sexes, in signs of insulin resistance, visceral obesity and, in women, hyperandrogenicity. In men a relative hypogonadism may be of importance. Experimental evidence suggests cause-effect relationships between these factors. In both sexes visceral fat may contribute to insulin resistance in the liver and the periphery by excess production of FFA. Hyperandrogenicity in women may also cause insulin resistance, although the reverse sequence of events cannot be excluded. The relative hypogonadism may well contribute to insulin resistance in men, as well as to the accumulation of visceral fat. There are observations of additional endocrine aberrations in visceral obesity, suggesting a central, neuroendocrine disturbance, which might be a primary factor for the pathogenesis of the syndrome.