Body Fat Partitioning Does Not Explain the Interethnic Variation in Insulin Sensitivity Among Asian Ethnicity: The Singapore Adults Metabolism Study

Khoo, Chin Meng; Leow, Melvin Khee–Shing; Sadananthan, Suresh Arnand; Lim, Radiance; Venkataraman, Kavita; Khoo, Eric Yin Hao; Velan, S. Sendhil; Ong, Yu Ting; Kambadur, Ravi; McFarlane, Craig; Gluckman, Peter D.; Lee, Yung Seng; Chong, Yap Seng; Tai, E. Shyong

doi:10.2337/db13-1483

Cited by 41 publications

(49 citation statements)

References 22 publications

(27 reference statements)

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“…32,33 Although the relationship between IMCL and metabolic function may depend on the training status of the subjects, 34 the correlations of IMCL with insulin sensitivity and insulin secretion in our study remained not significant even after adjusting for VO 2 max (r = −0.191, P = 0.152 and r = 0.208, P = 0.117; respectively). As our subjects were of Asian descent (predominantly Chinese), our findings are consistent with the results of Khoo et al 35 who reported weak associations between IMCL content and insulin sensitivity in all Asian ethnic groups, along with a reduced tendency for Chinese subjects to accumulate IMCL with increasing levels of adiposity. In addition, there are differences in IMCL content between different muscles, 36 thus we cannot rule out the possibility that the soleus is not a representative skeletal muscle with respect to the relationship between IMCL and whole-body insulin sensitivity.…”

Section: Discussionsupporting

confidence: 92%

Ectopic fat and aerobic fitness are key determinants of glucose homeostasis in nonobese Asians

Chan

Ding

Chooi

et al. 2019

Eur J Clin Investigation

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Background The importance of ectopic fat deposition and physical fitness in the pathogenesis of insulin resistance and beta cell dysfunction in subjects from the nonobese Asians is not known. Materials and methods We conducted a cross‐sectional study and measured insulin sensitivity (M value; 4‐hour hyperinsulinaemic‐euglycaemic clamp), insulin secretion rate (3‐hour mixed meal tolerance test with oral minimal modelling), percent body fat, visceral adipose tissue, intramyocellular and intrahepatic lipid contents (magnetic resonance imaging and spectroscopy), cardiorespiratory fitness (VO2max; graded exercise test) and habitual physical activity (short International Physical Activity Questionnaire) in 60 healthy nonobese Asian subjects (BMI = 21.9 ± 1.7 kg/m2, age = 41.8 ± 13.4 years). Results M was inversely associated with percent body fat (r = −0.460, P < 0.001), visceral fat (r = −0.623, P < 0.001) and liver fat (r = −0.601, P < 0.001), whereas insulin secretion correlated positively with these adiposity indices (percent body fat: r = 0.303, P = 0.018; visceral fat: r = 0.409, P = 0.010; hepatic fat: r = 0.393, P = 0.002). VO2max correlated negatively with insulin secretion rate (r = −0.420, P < 0.001) and positively with M (r = 0.658, P < 0.001). The amount of vigorous physical activity was positively associated with VO2max (r = 0.682, P < 0.001). Multiple stepwise linear regression analyses indicated that VO2max, age, and IHTG or VAT were independent determinants of insulin sensitivity and secretion (adjusted R2 = 69% and 33%, respectively, P < 0.001). Conclusions Increased ectopic fat deposition is associated with reduced insulin sensitivity and increased insulin secretion in healthy nonobese Asians. Poor cardiorespiratory fitness, likely due to inadequate participation in vigorous exercise, is strongly related to suboptimal metabolic function. Interventions to encourage engagement in physical activity may thus be important for improving metabolic health in nonobese Asians.

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Section: Discussionsupporting

confidence: 92%

Ectopic fat and aerobic fitness are key determinants of glucose homeostasis in nonobese Asians

Chan

Ding

Chooi

et al. 2019

Eur J Clin Investigation

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“…Moreover, previous comparisons of racial/ethnic groups have noted that even after adjustment for visceral, subcutaneous, and hepatic density, Asian Indians have lower insulin sensitivity using hyperinsulinemic euglycemic clamp studies compared with other Asian groups. 24 In turn, insulin sensitivity is a known modifier of lipid particle size and activity, with greater insulin resistance contributing to lower HDL levels. 25 Thus, relationships between sex hormones and HDL may have been attenuated in the current analysis.…”

Section: Discussionmentioning

confidence: 99%

Endogenous Sex Steroid Hormones, Lipid Subfractions, and Ectopic Adiposity in Asian Indians

Kim

Kong

Krauss³

et al. 2015

Metabolic Syndrome and Related Disorders

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Background: Estradiol, testosterone (T), and sex hormone binding globulin (SHBG) levels are associated with lipid subfractions in men and women. Our objective was to determine if associations are independent from adipose tissue area among Asian Indians. Methods: We used data from 42 women and 57 Asian Indian men who did not use exogenous steroids or lipidlowering medications. Lipoprotein subfractions including low-density lipoprotein cholesterol (LDL), very low-density lipoprotein cholesterol (VLDL), and intermediate density lipoprotein (IDL) were assessed by ion mobility spectrometry. Intra-abdominal adiposity was assessed by computed tomography. Multivariable regression models estimated the association between sex hormones with lipoprotein subfractions before and after adjustment for adiposity. Results: Among women, lower log SHBG levels were associated with smaller log LDL particle size and higher log triglycerides, log VLDL, and log IDL, although these associations were attenuated with adjustment for visceral adiposity in particular. Among women, lower log SHBG levels was significantly associated with lower log medium LDL and log small LDL concentrations even after consideration of visceral and hepatic adiposity and insulin resistance as represented by the homeostasis model assessment of insulin resistance (HOMA-IR). Among men, lower log SHBG was also associated with smaller log LDL peak diameter size and higher log triglycerides and log VLDL, even after adjustment for HOMA-IR and adiposity. Relationships between sex steroids and lipid subfractions were not significant among women. Among men, higher total testosterone was associated with higher log HDL and log LDL particle size, and lower log triglycerides and log VLDL, but these associations were partially attenuated with adjustment for adiposity and HOMA-IR. Conclusions: Among Asian Indians, SHBG is associated with more favorable lipid subfraction concentrations, independent of hepatic and visceral fat.

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“…Sex and ethnic differences in abdominal fat partitioning have been reported in adolescents and adults (11)(12)(13)(14)(15), with multiple studies showing that men have higher levels of VAT than women, which may partly explain their increased predisposition to metabolic diseases (11,12,16). The timing of this sexual dimorphism is not clear, with some reports indicating that it emerges even before puberty (17).…”

Section: Introductionmentioning

confidence: 99%

Association Between Early Life Weight Gain and Abdominal Fat Partitioning at 4.5 Years is Sex, Ethnicity, and Age Dependent

Sadananthan

Tint

Michael

et al. 2019

Obesity

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Objective To investigate the independent associations between age-specific annual weight gain from birth to age 4 years and fat deposition in metabolically distinct compartments at age 4.5 years in a South Asian longitudinal birth cohort. Methods Volumetric abdominal MRI with comprehensive segmentation of deep (DSAT) and superficial subcutaneous (SSAT), and visceral adipose tissues (VAT) was performed in 316 children (150 boys, and 166 girls in three ethnic groups: 158 Chinese, 94 Malay, and 64 Indian) aged 4.5 years. Associations between fat volumes and annual relative weight gain conditional on past growth were assessed overall and stratified by sex and ethnicity. Results Conditional relative weight gain had stronger associations with greater SAT and VAT at age 4.5 years in girls than boys, and in Indians compared with Malay and Chinese. Overall, the magnitude of association was the largest during 2-3 years for SAT, and 1-2 years for VAT. Despite similar body weight, Indian children, and girls had the highest DSAT and SSAT volumes at age 4.5 years (all p-interaction<0.05). No significant sex or ethnic differences were observed in VAT. With increasing BMI, Indian children had the highest tendency to accumulate VAT, and girls accumulated more fat than boys in all depots (all p-interaction<0.001). Conclusions Indian ethnicity and female sex predisposed children to accumulate more fat in the visceral adipose depot with increasing conditional relative weight gain in the second year of life. Thus, 1-2 years age may be a critical window for interventions to reduce visceral fat accumulation.

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Body Fat Partitioning Does Not Explain the Interethnic Variation in Insulin Sensitivity Among Asian Ethnicity: The Singapore Adults Metabolism Study

Cited by 41 publications

References 22 publications

Ectopic fat and aerobic fitness are key determinants of glucose homeostasis in nonobese Asians

Ectopic fat and aerobic fitness are key determinants of glucose homeostasis in nonobese Asians

Endogenous Sex Steroid Hormones, Lipid Subfractions, and Ectopic Adiposity in Asian Indians

Association Between Early Life Weight Gain and Abdominal Fat Partitioning at 4.5 Years is Sex, Ethnicity, and Age Dependent

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