Racial Disparity in Glucagon-Like Peptide 1 and Inflammation Markers Among Severely Obese Adolescents

Abstract

OBJECTIVE -Compared with Caucasians, obese African-American adolescents have a higher risk for type 2 diabetes. Subclinical inflammation and reduced glucagon-like peptide 1 (GLP-1) concentration are linked to the pathogenesis of the disease. We determined the relationship between insulin resistance, ␤-cell activity, and subclinical inflammation with GLP-1 concentrations and whether racial disparities in GLP-1 response were present in 49 obese adolescents (14 Ϯ 3 years; 76% African American; 71% female). RESEARCH DESIGN AND METHODS -Subjects underwent physical examinationand an oral glucose tolerance test. We measured levels of high-sensitivity CRP (CRP hs ), fibrinogen, glucose, GLP-1 total , GLP-1 active , and insulin. Insulin and glucose area under the curve (AUC), insulinogenic index (⌬I30/⌬G30), and composite insulin sensitivity index (CISI) were computed. Subjects were categorized by race and as inflammation positive (INFϩ) if CRP hs or fibrinogen were elevated.RESULTS -No racial differences were seen in mean or relative BMI. Thirty-five percent of subjects had altered fasting or 2-h glucose levels (African American vs. Caucasian, NS), and 75% were INFϩ (African American vs. Caucasian, P ϭ 0.046). Glucose and insulin, CISI, and ⌬I30/⌬G30 values were similar; African Americans had lower GLP-1 total AUC (P ϭ 0.01), GLP-1 active at 15 min (P ϭ 0.03), and GLP-1 active AUC (P ϭ 0.06) and higher fibrinogen (P ϭ 0.01) and CRP hs (NS) compared with Caucasians.

Determinants of blood levels of some thrombogenic biomarkers in healthy Arab adolescent subjects

“…In addition, the differences we have established in levels and relationships of some of these biomarkers, at least in relation to other populations (40,(43)(44)(45)(46) make our observations unique as a contribution to establishing a solid evidence base for the use of these markers in the prediction of cardiovascular disease risk in different populations. In addition, the differences we have established in levels and relationships of some of these biomarkers, at least in relation to other populations (40,(43)(44)(45)(46) make our observations unique as a contribution to establishing a solid evidence base for the use of these markers in the prediction of cardiovascular disease risk in different populations.…”

Race and Socioeconomic Differences in Obesity and Depression among Black and Non-Hispanic White Americans

“…In terms of obesity, physiological (e.g., inflammation, insulin resistance) 32,33 and health behavioral factors (e.g., poor dietary and exercise habits) 34 reportedly account for some of the observed racial/ethnic differences. Further, studies suggest that stress, in combination with health behaviors and obesogenic environments, explain both the higher prevalence of obesity and the lower prevalence of mental disorders, such as depression, among African Americans compared with other groups.…”

Entero-insular axis and postprandial insulin differences in African American and European American children

“…who found that among severely obese adolescents, AA had lower GLP-1 responses to oral glucose (17). Importantly, our results extend these findings to demonstrate for the first time that ethnic differences in GLP-1 are also present in healthy children with normal body weight and normal glucose tolerance.…”

“…To date, few investigations have quantified incretin responses in AA and EA. Obese AA adults were found to have significantly higher fasting and postchallenge GLP-1 concentrations than EA adults (16), however, recent findings in obese adolescents seem to contradict these findings (17). …”