Sex Differences in Glucose and Fatty Acid Metabolism in Asians Who Are Nonobese
Open accessAbstract
Context: The prevalence of diabetes is increasing throughout Asia, even in the absence of obesity, and is lower in women than in men. The underlying mechanisms are not well understood. Objective: To evaluate the sex differences in glucose and fatty acid metabolism in Asians who are nonobese. Design: Cross-sectional study. Setting: Clinical Nutrition Research Centre, Singapore. Participants: Healthy Asian men (n = 32; body mass index, 21.8 ± 1.5 kg/m2; age, 42 ± 14 years) and women (n = 28; body mass index, 21.4 ± 2.0 kg/m2; age, 41 ± 13 years). Main Outcome Measures: Insulin sensitivity (insulin-mediated glucose uptake normalized for steady-state insulin; hyperinsulinemic-euglycemic clamp), postprandial glucose, insulin and fatty acid concentrations, insulin secretion (mixed meal tolerance test with mathematical modeling), insulin clearance, body composition and fat distribution (dual-energy X-ray absorptiometry, MRI, and spectroscopy), cardiorespiratory fitness (maximal oxygen uptake; graded exercise test), and handgrip strength (dynamometry). Results: Women had more total body fat but less visceral fat than men; liver and muscle lipid contents were not different. Maximal oxygen uptake and handgrip strength were lower in women than men. The postprandial glucose concentrations were ~8% lower, the insulin-mediated glucose uptake was ~16% greater, and the meal-induced suppression of fatty acid concentrations was significantly greater in women than in men (P < 0.05 for all). However, muscle insulin sensitivity was not different between the sexes. No differences were found in postprandial insulin secretion and clearance rates; however, the steady-state insulin clearance was ~17% lower in women. Conclusions: Asian women who are nonobese are more insulin-sensitive than men at the level of adipose tissue but not skeletal muscle. Therefore, sex differences in glucose tolerance are likely the result of sexual dimorphism in hepatic insulin action.
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Triple tracer studies reported sex differences in rates of meal glucose appearance and disappearance and endogenous glucose production in response to a 10 kcal/kg standardized mixed meal.
“Other investigators have used sophisticated triple tracer techniques (that includes glucose tracers in the meal) to study postprandial glucose metabolism (155, 156); sex-differences in the rates of meal glucose appearance and disappearance, endogenous glucose production, in response to a 10 kcal/kg standardized mixed meal were reported.”
From Sex differences in the metabolism of glucose and fatty acids by adipose tissue and skeletal muscle in humans (2025) · cites this paper as [155]
The Results section reports a sex difference in postprandial glucose AUC after a mixed meal. But the Mixed meal tolerance test section specifies a fixed 600-kcal meal, not 10 kcal/kg, and describes measurements of glucose, C-peptide, and insulin rather than a triple-tracer assessment of meal glucose appearance, disappearance, and endogenous glucose production. Page numbers are unavailable in our copy. (LLM, conf=0.87)
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Type 2 diabetes, sex and metabolic dysfunction-associated steatotic liver disease
Lonardo, A., Jamalinia, M., & Weiskirchen, R. (2026) · World Journal of Diabetes · doi:10.4239/wjd.v17.i5.119756
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- Authors
- Chan, Z., Chooi, Y. C., Ding, C., Choo, J., Sadananthan, S. A., Michael, N., Velan, S. S., Leow, M. K., & Magkos, F.
- Affiliations
- Agency for Science, Technology and Research (SG)
- Corresponding author
- Magkos, Faidon
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2018-09-24
- Volume
- 104
- Issue
- 1
- Pages
- 127-136
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2893309815
- Cited by
- 34
- References
- 68
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 1 · 2021: 7 · 2020: 11 · 2019: 4
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- DR-NTU (Nanyang Technological University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Agency for Science, Technology and Research (BMSI/16-07803c-R20H)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- sex differences, glucose metabolism, fatty acid metabolism, insulin sensitivity, non-obese women, Asian women, postprandial blood glucose, insulin secretion, insulin clearance, hepatic insulin action, visceral fat, skeletal muscle insulin sensitivity, cardiorespiratory fitness, grip strength, diabetes risk
- MeSH terms
- Adult, Blood Glucose, Body Composition, Cross-Sectional Studies, Fatty Acids, Female, Glucose, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Physical Fitness, Sex Characteristics, Body Mass Index, Hand Strength, Asian People, Young Adult
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