The frequencies of Type II (non-insulin-dependent) diabetes mellitus, atherosclerosis and components of -syndrome X, such as insulin resistance and dyslipidaemia, vary considerably among ethnic groups. South Asians and black subjects have a higher prevalence of Type II diabetes and hypertension than white subjects. Black subjects, however, have a favourable lipid profile and thus a lower risk of coronary heart disease (CHD) than South Asians, who have a highrisk lipid profile and consequently a high prevalence of CHD [1±3]. Risk factors such as obesity and smoking also vary widely between ethnic groups: black women have a high prevalence of obesity while white subjects have a high prevalence of smoking [1]. Some of these differences in disease susceptibility might depend on cultural inheritance or on the environment, but genetic variation could also play a part.We have previously shown that a polymorphism in the insulin response element (IRE) of the apolipoprotein CIII (ApoCIII) gene promoter (±482C > T) Diabetologia (2001)
AbstractAims/hypothesis. The apolipoprotein C3±482C > T variant modulates insulin and glucose concentrations after an oral glucose tolerance test (OGTT) in young healthy white men. We evaluated the effect of this variant in different ethnic groups with different rates of Type II (non-insulin-dependent) diabetes mellitus and coronary heart disease. Methods. We investigated the ±482C > T in a population-based cross-sectional study of white subjects (n = 462), South Asians (n = 442) and subjects of West African and Afro-Caribbean origin (n = 462), whose OGTT and fasting plasma triglyceride concentrations had been measured. Results. The ±482T allele frequency differed between the three groups: 0.25 (95 % CI 0.22±0.28) in white subjects, 0.44 (0.41±0.47) in South Asians and 0.71 (0.68±0.74) in black subjects (p < 0.0001). A positive association was found between body mass index and genotype in black women (p = 0.009) and in black men (p = 0.056) but not in white subjects or South Asians. Associations between ±482C > T and fasting insulin were found in white subjects, where ±482T allele carriers had higher concentrations (adjusted for age and sex, p = 0.007, also including smoking and body mass index, p = 0.038). Higher triglyceride concentrations (p = 0.004 and p = 0.007 in the two models) but not glucose concentrations were also associated with ±482C > T. In black subjects, decreased fasting insulin (p = 0.04) and fasting glucose (p = 0.004) were associated with ±482C > T. No relation was observed between genotype and any post-load measures. Conclusions/interpretation. Allele frequencies of the ±482C > T and associations with insulin, glucose and triglyceride concentrations vary considerably among ethnic groups. Although the results are consistent among white subjects across different studies, the associations among black subjects and South Asians differ. [Diabetologia (2001) 44: 245±248]