Ethnic Differences in Secretion, Sensitivity, and Hepatic Extraction of Insulin in Black and White Americans

Osei, Kwame; Schuster, Dara

doi:10.1111/j.1464-5491.1994.tb00349.x

Cited by 158 publications

(163 citation statements)

References 27 publications

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“…Similarly, insulin clearance was lower in African Americans for a given insulin sensitivity tertile. Our finding that insulin clearance is lower in African Americans than in subjects of White European origin, thus contributing to higher peripheral insulin concentrations, is in agreement with several other studies [28,29]. The finding of a similar pattern of EIR adaptation to increasing insulin resistance across ethnic groups is at odds with a previous study [30], which demonstrated failure of such compensation in obese African American young people.…”

Section: Discussionsupporting

confidence: 90%

Ethnic differences in beta cell adaptation to insulin resistance in obese children and adolescents

et al. 2006

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Aims/hypothesis: The prevalence of altered glucose metabolism in obese children and adolescents is growing at a significant rate, especially in ethnic minorities. It is not clear whether young people of different ethnic backgrounds differ in their adaptive mechanisms to obesityrelated insulin resistance. The aim of this study was to evaluate the early insulin response and insulin clearance in response to an oral glucose load in obese children and adolescents. Methods: Seven hundred and nine obese children and adolescents underwent an OGTT. Indices of the early insulin response and insulin clearance were compared in participants of White European, African American and Hispanic origin. Results: Participants of the three ethnic groups demonstrated similar mechanisms of adaptation to increasing insulin resistance, but with different magnitudes. African American subjects had a greater early insulin response and decreased insulin clearance than their White European and Hispanic counterparts. This happened regardless of whether the cohort was divided by glucose tolerance level or by level of insulin sensitivity. IGT across ethnic groups was characterised by a marked decline in the acute insulin response in the context of severe insulin resistance and very low insulin clearance. Conclusions/ interpretation: In obese children and adolescents, mechanisms of adaptation to obesity related to insulin resistance are similar across ethnic groups. The greater early insulin response needed to maintain glucose tolerance in young people of ethnic minorities may partially explain their greater tendency to develop type 2 diabetes.

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Section: Discussionsupporting

confidence: 90%

Ethnic differences in beta cell adaptation to insulin resistance in obese children and adolescents

et al. 2006

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“…As proinsulin and insulin have different MCRs (35,36), the ratio of circulating proinsulin-to-insulin is controlled by the rates of secretion and clearance of both proinsulin and insulin. Furthermore, there is considerable intra-and inter-individual variation in the clearance of insulin, especially in hepatic insulin extraction, in many different physiological (37) and pathological conditions (38). Since C-peptide accurately re¯ects the b cell secretory capacity (39) and, similarly to proinsulin, the hepatic extraction of C-peptide is negligible (40,41), the ratio of proinsulin-to-C-peptide may be considered as a better indicator of distressed b cells than is the ratio of proinsulin-to-insulin.…”

Section: Controlsmentioning

confidence: 99%

Hyperproinsulinemia is not a characteristic feature in the offspring of patients with different phenotypes of type II diabetes

Vauhkonen

Niskanen²,

Mykkänen³

et al. 2000

European Journal of Endocrinology

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Objective: The purpose of this work was to study whether there are differences in plasma proinsulin levels and proinsulin-to-speci®c insulin ratio in the offspring of patients with different phenotypes of type II diabetes. Design: Eleven glucose-tolerant offspring of type II diabetic patients with de®cient insulin secretion phenotype (IS group), nine glucose-tolerant offspring of patients with insulin-resistant phenotype (IR group), and fourteen healthy control subjects without a family history of diabetes were studied. Methods: Plasma speci®c insulin, plasma proinsulin, and plasma C-peptide levels were measured during a 2-h oral glucose tolerance test and during hyperglycemic clamp. Results: Plasma proinsulin levels during the oral glucose tolerance test and the hyperglycemic clamp did not differ among the study groups. The IR group had a lower fasting plasma proinsulin-to-speci®c insulin ratio (10.3 6 1.7%) than the control group (15.4 6 1.4%; P < 0.05) and the IS group (18.6 6 2.7%; P < 0.05). Furthermore, the IR group had lower plasma proinsulin-to-speci®c insulin ratio at 30, 60 and 90 min after the oral glucose load than the IS group. However, there were no signi®cant differences in proinsulin-to-C-peptide ratio during the oral glucose tolerance test among the study groups. In stepwise multiple regression analysis, hepatic speci®c insulin extraction in the fasting state (b 0.65; P < 0.001) and fasting blood glucose (b 0.32; P < 0.05) together explained 52% of the variation in fasting plasma proinsulin-to-speci®c insulin ratio. Conclusions: Hyperproinsulinemia is not a characteristic ®nding in glucose-tolerant offspring of type II diabetic probands with de®cient insulin secretion or insulin-resistant phenotype. The differences in proinsulin-to-speci®c insulin ratios were most likely explained by different hepatic extraction among the study groups.

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“…Nondiabetic black and MexicanAmerican subjects appear to have decreased insulin sensitivity when compared with white subjects (12). Previous studies have shown that there may be ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans (13). Mexican-American subjects have higher insulin levels than white subjects, even after adjustment for BMI (14).…”

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confidence: 98%

Heterogeneity in the Relationship Between Ethnicity, BMI, and Fasting Insulin

2002

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OBJECTIVE -To determine whether the association of BMI and fasting insulin is modified by ethnicity.RESEARCH DESIGN AND METHODS -Non-Hispanic black (black), non-Hispanic white (white), and Mexican-American men and women aged 20 -80 years from the Third National Health and Nutrition Examination Survey (1988 -1994) were included in this study. Linear regression models with an interaction term were used to test whether ethnicity modified the association between BMI and fasting insulin. 19, 26, 20, and 19% higher in black women than white women with BMI levels of Ͻ22, 22-24, 25-27, and 28 -30 kg/m 2 , respectively. These differences between black and white women converged at BMI levels Ͼ30 kg/m 2 . Mexican-American women had fasting insulin levels that were 17, 22, 20, and 16% higher than those of white women at BMI levels of 25-27, 28 -30, 31-33, and Ͼ34 kg/m 2 , respectively, but were not different in individuals with BMI levels Ͻ25 kg/m 2 . Adjusting for established risk factors did not attenuate these associations in women. Differences in fasting insulin among men were not as apparent. RESULTS -Fasting insulin wasCONCLUSIONS -These findings suggest that the effect of obesity on insulin sensitivity is different for Americans in ethnic minorities. In black subjects, fasting insulin is higher at lean weight when compared with white and Mexican-American subjects. In Mexican-American subjects, fasting insulin is higher in overweight individuals when compared with white and black subjects. These findings are more pronounced in women than in men. This result reinforces the importance of designing prevention programs that are tailored to meet the needs of specific populations. Investigation of possible explanations for these differences seems warranted.

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Ethnic Differences in Secretion, Sensitivity, and Hepatic Extraction of Insulin in Black and White Americans

Cited by 158 publications

References 27 publications

Ethnic differences in beta cell adaptation to insulin resistance in obese children and adolescents

Ethnic differences in beta cell adaptation to insulin resistance in obese children and adolescents

Hyperproinsulinemia is not a characteristic feature in the offspring of patients with different phenotypes of type II diabetes

Heterogeneity in the Relationship Between Ethnicity, BMI, and Fasting Insulin

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