Higher Acute Insulin Response to Glucose May Determine Greater Free Fatty Acid Clearance in African-American Women
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CONTEXT: Obesity and diabetes are more common in African-Americans than whites. Because free fatty acids (FFA) participate in the development of these conditions, studying race differences in the regulation of FFA and glucose by insulin is essential. OBJECTIVE: The objective of the study was to determine whether race differences exist in glucose and FFA response to insulin. DESIGN: This was a cross-sectional study. SETTING: The study was conducted at a clinical research center. PARTICIPANTS: Thirty-four premenopausal women (17 African-Americans, 17 whites) matched for age [36 ± 10 yr (mean ± sd)] and body mass index (30.0 ± 6.7 kg/m²). INTERVENTIONS: Insulin-modified frequently sampled iv glucose tolerance tests were performed with data analyzed by separate minimal models for glucose and FFA. MAIN OUTCOME MEASURES: Glucose measures were insulin sensitivity index (S(I)) and acute insulin response to glucose (AIRg). FFA measures were FFA clearance rate (c(f)). RESULTS: Body mass index was similar but fat mass was higher in African-Americans than whites (P < 0.01). Compared with whites, African-Americans had lower S(I) (3.71 ± 1.55 vs. 5.23 ± 2.74 [×10⁻⁴ min⁻¹/(microunits per milliliter)] (P = 0.05) and higher AIRg (642 ± 379 vs. 263 ± 206 mU/liter⁻¹ · min, P < 0.01). Adjusting for fat mass, African-Americans had higher FFA clearance, c(f) (0.13 ± 0.06 vs. 0.08 ± 0.05 min⁻¹, P < 0.01). After adjusting for AIRg, the race difference in c(f) was no longer present (P = 0.51). For all women, the relationship between c(f) and AIRg was significant (r = 0.64, P < 0.01), but the relationship between c(f) and S(I) was not (r = -0.07, P = 0.71). The same pattern persisted when the two groups were studied separately. CONCLUSION: African-American women were more insulin resistant than white women, yet they had greater FFA clearance. Acutely higher insulin concentrations in African-American women accounted for higher FFA clearance.
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African Americans compared to European Americans have higher AIRg.
“Additionally, AA compared to EA as a group, have higher AIRg [23], which has been attributed to both greater beta-cell responsivity and lower hepatic insulin extraction [24].”
From Defining and Characterizing Postprandial Reactive Hypoglycemia (2026) · cites this paper as [23]
The Glucose minimal model section reports higher AIRg in African-American than white women (642 ± 379 versus 263 ± 206; P < 0.01). The cited study included only premenopausal women, so it does not establish the unqualified comparison between African Americans and European Americans as groups. (LLM, conf=0.85)
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Haffner, S. M., Ralph, D., Saad, M. F., Rewers, M., Mykkänen, L., Selby, J., Howard, G., Savage, P. J., Hamman, R. F., Wegenknecht, L. E., et al. (1996) · Diabetes · doi:10.2337/diab.45.6.742 · Cited by 536 · see citing works
Ethnic differences in the ability of triglyceride levels to identify insulin resistance
Sumner, A. E., & Cowie, C. C. (2008) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2006.12.018 · Cited by 273 · see citing works
Self-citationGender differences in regional fatty acid metabolism before and after meal ingestion.
Jensen, M. D. (1995) · Journal of Clinical Investigation · doi:10.1172/jci118285 · Cited by 191 · see citing works
Burst-like control of lipolysis by the sympathetic nervous system in vivo
Hücking, K., Hamilton-Wessler, M., Ellmerer, M., & Bergman, R. N. (2003) · Journal of Clinical Investigation · doi:10.1172/jci14466 · Cited by 89 · see citing works
Nonoxidative Free Fatty Acid Disposal Is Greater in Young Women than Men
Koutsari, C., Basu, R., Rizza, R. A., Nair, K. S., Khosla, S., & Jensen, M. D. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1651 · Cited by 51 · see citing works
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Golden, S. H., Brown, A., Cauley, J. A., Chin, M. H., Gary-Webb, T. L., Kim, C., Sosa, J. A., Sumner, A. E., & Anton, B. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2043 · Cited by 405 · see citing works
Self-citationPiccinini, F., Polidori, D. C., Gower, B. A., & Bergman, R. N. (2017) · Diabetes · doi:10.2337/db17-0413 · Cited by 73 · see citing works
“, at the beginning of the test) when circulating insulin is only due to endogenous secretion (mean AUC0–20 min for plasma insulin is 110% higher in AAs than in EAs), whereas the difference between AAs and EAs is minimal after the insulin infusion, confirming previous reports (16,27).”
ResultDefining and Characterizing Postprandial Reactive Hypoglycemia
Sweatt, S. K., Thomas, D. M., LaPorte, G. J., Chauff, S., Stefanovski, D., & Gower, B. A. (2026) · Nutrients · doi:10.3390/nu18050822 · Cited by 2 · see citing works
- Authors
- Chow, C. C., Periwal, V., Csako, G., Ricks, M., Courville, A. B., Miller, B. V., Vega, G. L., & Sumner, A. E.
- Affiliations
- National Institutes of Health (US)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Sumner, Anne E.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2011-08
- Volume
- 96
- Issue
- 8
- Pages
- 2456-2463
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3146797
- OpenAlex
- W2167280444
- Cited by
- 50
- References
- 5
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 4 · 2012: 5
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hologic
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- acute insulin response to glucose, racial differences, African American women, insulin sensitivity, insulin resistance, glucose tolerance, fat mass, obesity, diabetes mellitus, minimal model analysis, premenopausal women
- MeSH terms
- Adipose Tissue, Adult, Black or African American, Blood Glucose, Cross-Sectional Studies, Disease Susceptibility, Fatty Acids, Nonesterified, Female, Glucose Tolerance Test, Humans, Insulin, Middle Aged, Models, Biological, Prevalence, Glucose Intolerance, White People
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