Glucose Tolerance, Insulin Secretion, and Insulin Sensitivity in Nonobese and Obese Japanese Subjects

Matsumoto, Kazunari; Miyake, Seibei; Yano, Mototake; Ueki, Yukitaka; Yamaguchi, Yoshihiko; Akazawa, Shoichi; Tominaga, Yuko

doi:10.2337/diacare.20.10.1562

Cited by 189 publications

(153 citation statements)

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“…Thus, among populations such as Pima Indians and Mexican-Americans that have high prevalences of overweight and obesity, insulin resistance may play a more important role than beta-cell dysfunction. 24,25 In contrast, it has been suggested that the primary etiological factor in the development of type 2 diabetes among Japanese, 26 Japanese-Americans 27 and Koreans 28 may involve beta-cell dysfunction that may be highly inheritable. 29 It is conceivable that ethnic differences in the relative importance of insulin resistance and beta-cell function may differentially effect fasting and post-challenge glucose concentrations in various populations, thus explaining the differential pattern of fasting and post-challenge glucose concentrations observed in our study.…”

Section: Discussionmentioning

confidence: 94%

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project

et al. 2002

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OBJECTIVE: To investigate the relationship between fasting glucose and 2 h glucose with percentage of Hawaiian ancestry and ethnic admixture. DESIGN: Cross-sectional epidemiological study of type 2 diabetes and heart disease risk factor prevalence among Native Hawaiians. SUBJECTS: A total of 578 Native Hawaiians residing in two rural communities were examined between 1993 and 1996. Sample sizes in statistical analyses varied due to missing data and selection criteria based on ethnic ancestry. MEASUREMENTS: Percentage of Hawaiian ancestry and non-Hawaiian ethnic admixture, assessed by self-report. Fasting and 2 h post glucose challenge plasma glucose levels. Anthropometric measures (height, weight, waist and hip circumferences). Selfreport of diet and physical activity. Medical history. RESULTS: Increased Hawaiian blood quantum was significantly associated with increased fasting glucose (P ¼ 0.0047), increased body mass index (BMI; P < 0.0001), waist-to-hip ratio (WHR; P ¼ 0.0103), and age (P < 0.0001), but not with leisure time physical activity and total dietary caloric intake. This association was attenuated after adjusting for BMI and WHR, but not by age-adjustment alone. However, when the effects of descent from other ethnic groups was examined in a subset of participants, full-Hawaiians had significantly higher fasting glucose concentrations (7.28 mmol=l) than part-Hawaiians after adjustments for age, gender, BMI and WHR. In contrast, part-Hawaiians of predominantly Asian ancestry had the highest 2 h glucose concentrations (7.62 mmol=l). CONCLUSION: These results suggest that ethnic admixture may be an important, but extremely complex, factor concerning the high prevalence of type 2 diabetes observed among this population. The complexity of this relationship may have obscured the relationship between ancestry and glucose tolerance in earlier observations of this population.

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Section: Discussionmentioning

confidence: 94%

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project

et al. 2002

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“…In contrast, insulin deficiency rather than insulin resistance has been reported to play a prominent role in the progression of diabetes in Japanese subjects [36]. Thus the insulin secretory inferiority could partly explain the higher prevalence of diabetes in non-obese Japanese and Chinese populations compared to European populations.…”

Section: Discussionmentioning

confidence: 97%

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

Group

2003

Diabetologia

172

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Aims/hypothesis. The aim of this study was to assess the effect of ethnicity on the association between age and body mass index as well as the prevalence of diabetes. Methods. We selected population-based studies carried out after 1980 in the DECODE/A studies representing different ethnic groups: 11 European, 1 Maltese, 3 Indian, 2 Chinese and 3 Japanese surveys. The total numbers of subjects were 14,240 men and 15,129 women who were 30 to 89 years of age. Diabetes was diagnosed according to the 1999 World Health Organization criteria based on a standard 75 g OGTT. Sexspecific prevalence of diabetes by age and BMI was stratified by ethnic group, in particular the interaction of ethnicity on the associations between age/BMI and the prevalence of diabetes.Results. The prevalence of diabetes was higher in studies from India and Malta compared to Japan, China, and the rest of Europe. The association between BMI and diabetes, adjusted for age, showed noticeable differences between the ethnic groups with an increase in prevalence starting at a BMI between 15 and 20 kg/m 2 in the Maltese and Indian populations compared to 25 kg/m 2 in Europeans. Conclusion/interpretation. The effect of BMI on the age-adjusted prevalence of Type 2 diabetes was modified by ethnicity with considerably lower thresholds in Indian and Maltese subjects compared to those from the rest of Europe. This difference should be reflected in national and international recommendations regarding "optimal" BMI.

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“…There is a growing body of evidence that the pathophysiology of type 2 diabetes differs by ethnic group [2][3][4]. Comparing Asian and white patients with type 2 diabetes, Asian patients are characterised by a relatively lower BMI [4], higher amounts of visceral fat with a given BMI or waist circumference [5,6] and a predominant insulin secretory defect [7][8][9]. In patients with type 2 diabetes, the insulin secretory defect is more prominent in Asian than in white individuals [7,10,11].…”

Section: Introductionmentioning

confidence: 99%

Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

et al. 2013

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Aims/hypothesis The aim of this work was to compare the glucose-lowering efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors between Asian and non-Asian patients with type 2 diabetes. Methods We searched MEDLINE, EMBASE, LILACS, CENTRAL, ClinicalTrials.gov and conference proceedings. Studies were eligible if they were randomised controlled trials with a treatment duration of at least 12 weeks, compared a DPP-4 inhibitor with a placebo as either monotherapy or oral combination therapy, had information on ethnicity and HbA 1c values and were published or described in English. A systematic review and meta-analysis with a meta-regression analysis was conducted. Results Among 809 potentially relevant studies, 55 trials were included. A meta-analysis revealed that DPP-4 inhibitors lowered HbA 1c to a greater extent in studies with ≥50% Asian participants (weighted mean difference [WMD] −0.92%; 95% CI −1.03, −0.82) than in studies with <50% Asian participants (WMD −0.65%; 95% CI −0.69, −0.60). The between-group difference was −0.26% (95% CI −0.36, −0.17, p<0.001). The baseline BMI significantly correlated with the HbA 1c -lowering efficacy of DPP-4 inhibitors. The RR of achieving the goal of HbA 1c <7.0% (53.0 mmol/mol) was higher in studies with ≥50% Asian participants (3.4 [95% CI 2.6, 4.7] vs 1.9 [95% CI 1.8, 2.0]). The fasting plasma glucose-lowering efficacy was higher with monotherapy in the Asiandominant studies, but the postprandial glucose-lowering efficacy and changes in body weight were comparable between the two groups. Conclusions/interpretation DPP-4 inhibitors exhibit a better glucose-lowering efficacy in Asians than in other ethnic groups; this requires further investigation to understand the underlying mechanism, particularly in relation to BMI.

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Glucose Tolerance, Insulin Secretion, and Insulin Sensitivity in Nonobese and Obese Japanese Subjects

Cited by 189 publications

References 0 publications

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project

Age, body mass index and Type 2 diabetes?associations modified by ethnicity

Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis

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