Insulin Resistance and Vascular Dysfunction in Nondiabetic Asian Indians
Abstract
Asian Indians are at higher risk for diabetes and cardiovascular disease than European Caucasians. To examine the pathophysiology of this increased risk, we measured insulin sensitivity, cardiovascular risk factors, fat distribution, and endothelium-dependent (reactive hyperemia) and -independent (nitroglycerin) vasodilation before and after a 2-h hyperinsulinemic clamp (40 mU/m(2).min) in 25 nondiabetic Asian Indians and 15 Caucasians with similar age and body mass index. Asian Indians had higher fasting insulin than Caucasians (6.7 +/- 0.8 vs. 3.7 +/- 0.3 microU/ml, P = 0.007) but similar FPG (90 +/- 2 vs. 88 +/- 2 mg/dl). Glucose uptake during the clamp was markedly reduced in Asian Indians vs. Caucasians (4.5 +/- 0.3 vs. 7.5 +/- 0.4 mg/kg x min, P < 0.0001). During the clamp, basal brachial artery diameter increased less in Asian Indians vs. Caucasians (2.6 +/- 1.0 vs. 5.7 +/- 1.0%, P = 0.04), and the reduction was correlated with the impairment in insulin sensitivity (r = 0.38, P = 0.04). In contrast, vasodilatory responses to reactive hyperemia and nitroglycerin were similar in Asian Indians and Caucasians both before and during hyperinsulinemia. Plasminogen activator inhibitor-1 and FFA were significantly elevated and adiponectin was significantly lower in Asian Indians vs. Caucasians, and there were trends toward higher low-density lipoprotein and triglycerides, lower high-density lipoprotein, and increased total, sc, and visceral fat. These risk factors were all significantly correlated with insulin sensitivity. Thus, apparently healthy Asian Indians have severe insulin resistance, dyslipidemia, elevated plasminogen activator inhibitor-1, impaired insulin-mediated vasodilation, and trends toward altered body fat distribution. These abnormalities may contribute to the increased risk of diabetes and cardiovascular disease in this population.
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Type 2 diabetes mellitus is strongly associated with obesity in most, but not all, ethnic groups, suggesting important ethnic differences in disease susceptibility.
“Type 2 diabetes mellitus (T2DM) is strongly associated with obesity in most, but not all, ethnic groups, suggesting important ethnic differences in disease susceptibility.”
From Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men (2006) · cites this paper as [6]
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- Authors
- Raji, A., Gerhard-Herman, M. D., Warren, M., Silverman, S. G., Raptopoulos, V., Mantzoros, C. S., & Simonson, D. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Raji, Annaswamy
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-08
- Volume
- 89
- Issue
- 8
- Pages
- 3965-3972
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2009039817
- Cited by
- 98
- References
- 53
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 4 · 2022: 4 · 2020: 1 · 2019: 1 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 9 · 2012: 8
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K23 DK604662)
- National Center for Research Resources (M01 RR 02635, M01RR002635)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- insulin resistance, Asian Indians, vascular dysfunction, endothelial function, hyperinsulinemic-euglycemic clamp, glucose uptake, brachial artery diameter, reactive hyperemia, plasminogen activator inhibitor-1, free fatty acids, adiponectin, dyslipidemia, body fat distribution, cardiovascular risk, ethnic differences
- MeSH terms
- Abdomen, Adipose Tissue, Adult, Brachial Artery, Cardiovascular Diseases, Fatty Acids, Nonesterified, Humans, India, Insulin, Insulin Resistance, Middle Aged, Proteins, Radiography, Risk Factors, Triglycerides, Ultrasonography, United States, Vasodilation, Case-Control Studies, Intercellular Signaling Peptides and Proteins, Subcutaneous Tissue, White People, Asian People, Adiponectin
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