Body Fat Distribution and Insulin Resistance in Healthy Asian Indians and Caucasians
Abstract
Previous studies have shown that Asian Indians (AIs) are insulin resistant and at high risk for developing diabetes and coronary heart disease, compared with Caucasians. To examine whether differences in body fat distribution contribute to this risk, 12 healthy AIs and 12 Caucasians matched for age and body mass index (BMI) underwent a 75-g oral glucose tolerance test, 2-h euglycemic hyperinsulinemic clamp, abdominal (L2-3) computed tomography scan, and fasting lipid and plasminogen activator inhibitor-1 (PAI-1) levels. Despite similar fasting plasma glucose levels, AIs exhibited fasting hyperinsulinemia (P = 0.001), higher glucose (P = 0.03) and insulin (P = 0.004) levels during the oral glucose tolerance test, and reduced glucose disposal rate (R(d)) (4.7 +/- 0.4 vs. 7.5 +/- 0.3 mg/kg per min, P < 0.0001) during the clamp. AIs had significantly lower high-density lipoprotein, higher low-density lipoprotein, and significantly higher PAI-1 levels (P = 0.01). Despite similar BMI, AIs had significantly greater total abdominal fat (P = 0.04) and visceral fat (P = 0.04). In all subjects, measures of fat mass were inversely correlated with R(d) during the clamp (r = -0.47 to -0.61, P < 0.01-0.001). Visceral fat mass was correlated with triglycerides, low-density lipoprotein, and high-density lipoprotein (P < 0.002-0.0001). PAI-1 was inversely correlated with R(d) in AIs (r = -0.70, P < 0.01) and not in Caucasians (r = -0.24, P = 0.44). For comparable BMI and age, healthy AIs have physiologic markers for insulin resistance, dyslipidemia, and increased cardiovascular risk, compared with Caucasians. Alterations in body fat distribution--particularly increased visceral fat--may contribute to these abnormalities.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Young Indians living in India have more visceral and abdominal fat and reduced glucose disposal rates than Caucasians with matched age and BMI.
“Young Indians living in India were found to have more visceral and abdominal fat and reduced glucose disposal rates than Caucasians with matched age and BMI [40].”
From Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity (2024) · cites this paper as [40]
Cited by
Sorted by citations
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961 · see citing works
DE HERT, M., CORRELL, C. U., BOBES, J., CETKOVICH‐BAKMAS, M., COHEN, D., ASAI, I., DETRAUX, J., GAUTAM, S., MÖLLER, H., NDETEI, D. M., et al. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00014.x · Cited by 2,488 · see citing works
“Accumulating evidence argues that lower cutoff points for WC should be used for Asians, as this population is prone to obesity-related morbidity and mortality at shorter WCs (52-56).”
BackgroundEinarson, T. R., Acs, A., Ludwig, C., & Panton, U. H. (2018) · Cardiovascular Diabetology · doi:10.1186/s12933-018-0728-6 · Cited by 2,312 · see citing works
“[60] noted that compared with Caucasians, Asian Indians had significantly greater total abdominal and visceral fat matched with Caucasians of the same age, gender, and BMI, meaning that this population has an increased CVD risk.”
ResultChait, A., & den Hartigh, L. J. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00022 · Cited by 1,529 · see citing works
“Cross-sectional studies in men of European, Asian Indian, and American descent have shown that total, visceral, and subcutaneous adiposity, BMI, and waist circumference are all negatively associated with insulin sensitivity (368, 369).”
BackgroundObesity and the metabolic syndrome in developing countries.
Misra, A., & Khurana, L. (2008) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2008-1595 · Cited by 1,332 · see citing works
“In addition, despite lower BMI and waist circumference, Asian Indians had significantly lower glucose disposal rates during the hyperinsulinemic euglycemic clamp, higher procoagulant tendency, and dyslipidemia compared with white Caucasians (85, 89).”
BackgroundRamachandran, A., Wan Ma, R. C., & Snehalatha, C. (2010) · The Lancet · doi:10.1016/s0140-6736(09)60937-5 · Cited by 782 · see citing works
Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men
Finkelstein, J. S., Lee, H., Burnett-Bowie, S.-A. M., Pallais, J. C., Yu, E. W., Borges, L. F., Jones, B. F., Barry, C. V., Wulczyn, K. E., Thomas, B. J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1206168 · Cited by 782 · see citing works
Lear, S. A., Humphries, K., Kohli, S., Chockalingam, A., Frohlich, J. J., & Birmingham, C. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.2.353 · Cited by 614 · see citing works
“9 16 (17) 28 (28) 40 (40) 49 (42) 33 (33) 34 (34) 32 (31) 35 (34)”
BackgroundResultInfluentialWhat aspects of body fat are particularly hazardous and how do we measure them?
Snijder, M., van Dam, R. V., Visser, M., & Seidell, J. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyi253 · Cited by 614 · see citing works
Sleep Restriction for 1 Week Reduces Insulin Sensitivity in Healthy Men
Buxton, O. M., Pavlova, M., Reid, E. W., Wang, W., Simonson, D. C., & Adler, G. K. (2010) · Diabetes · doi:10.2337/db09-0699 · Cited by 604 · see citing works
“Insulin sensitivity was measured using the insulin clamp procedure as previously described (35).”
MethodSelf-citationTrends in prevalence of diabetes in Asian countries.
Ramachandran, A., Snehalatha, C., Shetty, A. S., & Nanditha, A. (2012) · World Journal of Diabetes · doi:10.4239/wjd.v3.i6.110 · Cited by 586 · see citing works
The metabolic syndrome: is this diagnosis necessary?
Reaven, G. (2006) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/83.6.1237 · Cited by 546 · see citing works
“IMGU was somewhat greater in 8 of the 12 comparisons than was that of VF and IMGU (83, 84, 86, 91, 94, 98, 101).”
ResultObesity-related non-communicable diseases: South Asians vs White Caucasians
Misra, A., & Khurana, L. (2011) · International Journal of Obesity · doi:10.1038/ijo.2010.135 · Cited by 491 · see citing works
Rush, E., Freitas, I., & Plank, L. (2009) · British Journal of Nutrition · doi:10.1017/s0007114508207221 · Cited by 465 · see citing works
Insulin resistance: the link between obesity and cardiovascular disease.
Reaven, G. (2011) · The Medical clinics of North America · doi:10.1016/j.mcna.2011.06.002 · Cited by 458 · see citing works
Amarapurkar, D., Hashimoto, E., Lesmana, L. A., Sollano, J., Chen, P.-J., & Goh, K. (2007) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2007.05042.x · Cited by 437 · see citing works
Preis, S., Massaro, J., Robins, S. J., Hoffmann, U., Vasan, R., Irlbeck, T., Meigs, J., Sutherland, P., D'Agostino, R. B., O'Donnell, C. J., et al. (2010) · Obesity · doi:10.1038/oby.2010.59 · Cited by 430 · see citing works
Misra, A., & Vikram, N. (2004) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2004.01.020 · Cited by 423 · see citing works
The Metabolic Syndrome in South Asians: Epidemiology, Determinants, and Prevention
Misra, A., & Khurana, L. (2009) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2009.0024 · Cited by 404 · see citing works
“16,72,76,81,82”
Contribution of Adipose Tissue Inflammation to the Development of Type 2 Diabetes Mellitus
Burhans, M. S., Hagman, D. K., Kuzma, J. N., Schmidt, K. A., & Kratz, M. (2018) · Comprehensive physiology · doi:10.1002/cphy.c170040 · Cited by 427 · see citing works
Metabolic Syndrome Pathophysiology and Predisposing Factors
Bovolini, A., Garcia, J., Andrade, M. A., & Duarte, J. A. (2020) · International Journal of Sports Medicine · doi:10.1055/a-1263-0898 · Cited by 414 · see citing works
“The genetic predisposition may explain why lean subjects such as southern Asian ethnic groups or metabolically healthy obese individuals are or are not, respectively, more prone to develop MetS [116, 117].”
BackgroundMisra, A., Vikram, N. K., Gupta, R., Pandey, R. M., Wasir, J. S., & Gupta, V. P. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803111 · Cited by 332 · see citing works
Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity
Wu, Y., Li, D., & Vermund, S. H. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21060757 · Cited by 332 · see citing works
“Young Indians living in India were found to have more visceral and abdominal fat and reduced glucose disposal rates than Caucasians with matched age and BMI [40].”
BackgroundRising Burden of Obesity in Asia
Ramachandran, A., & Snehalatha, C. (2010) · Journal of Obesity · doi:10.1155/2010/868573 · Cited by 332 · see citing works
“It has also been noted that for a given BMI, Asians have higher body fat percentage compared with Caucasians [56, 57].”
ResultMisra, A., & Vikram, N. (2003) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/s0899-9007(02)01003-1 · Cited by 329 · see citing works
Point: Visceral Adiposity Is Causally Related to Insulin Resistance
Lebovitz, H. E., & Banerji, M. A. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2322 · Cited by 328 · see citing works
“The hypothesis that visceral adiposity and not total adiposity was the cause of the components and clinical consequences of the metabolic syndrome has been challenged by several studies that found either that abdominal subcutaneous adipose tissue mass and not visceral adipose tissue mass was independently correlated w…”
ResultInfluence of body fat content and distribution on variation in metabolic risk
Vega, G. L., Adams-Huet, B., Peshock, R., Willett, D., Shah, B., & Grundy, S. M. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0814 · Cited by 312 · see citing works
Misra, A., Wasir, J., & Vikram, N. (2005) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2005.01.007 · Cited by 309 · see citing works
Obesity and Dyslipidemia in South Asians
Misra, A., & Shrivastava, U. (2013) · Nutrients · doi:10.3390/nu5072708 · Cited by 307 · see citing works
“In this context, it is important to note that adipocyte cell size was significantly higher in South Asians (3491 ± 1393 µm 2 ) as compared to white Caucasians in USA (1648 ± 864 µm 2 ; p-value = 0.0001) [74].”
ResultInfluentialMigration and its impact on adiposity and type 2 diabetes.
Misra, A., & Ganda, O. (2007) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/j.nut.2007.06.008 · Cited by 303 · see citing works
“[38] Raji A, Seely EW, Arky RA, Simonson DC.”
BackgroundThe impact of ethnicity on type 2 diabetes.
Abate, N., & Chandalia, M. (2003) · Journal of diabetes and its complications · doi:10.1016/s1056-8727(02)00190-3 · Cited by 300 · see citing works
Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups
Lear, S., James, P. T., Ko, G., & Kumanyika, S. (2010) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2009.70 · Cited by 297 · see citing works
Misra, A. (2015) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2015.0007 · Cited by 292 · see citing works
“Although the average waist circumference in South Asians appears to be lower, abdominal adiposity is significantly more than in Caucasians.(8,18) Fat deposition in other tissues also may affect insulin sensitivity.”
BackgroundInfluentialStandardized assessment of whole body adipose tissue topography by MRI
Machann, J., Thamer, C., Schnoedt, B., Haap, M., Haring, H., Claussen, C., Stumvoll, M., Fritsche, A., & Schick, F. (2005) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.20292 · Cited by 266 · see citing works
“As CT is often applied as a single slice modality (13) due to the inherent drawback of exposure to ionizing radiation for the volunteers, MRI seems to be the most promising imaging tool for assessment of total body adipose tissue distribution (14,15).”
Body composition phenotypes in pathways to obesity and the metabolic syndrome
Dulloo, A. G., Jacquet, J., Solinas, G., Montani, J.-P., & Schutz, Y. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.234 · Cited by 268 · see citing works
Hocking, S. L., Samocha-Bonet, D., Milner, K.-L., Greenfield, J., & Chisholm, D. (2013) · Endocrine reviews · doi:10.1210/er.2012-1041 · Cited by 261 · see citing works
“related to abdominal and visceral fat (125, 126).”
BackgroundEnas, E., Mohan, V., Deepa, M., Farooq, S., Pazhoor, S., & Chennikkara, H. (2007) · Journal of the CardioMetabolic Syndrome · doi:10.1111/j.1559-4564.2007.07392.x · Cited by 254 · see citing works
Insulin resistance and body fat distribution in South Asian men compared to Caucasian men
Chandalia, M., Lin, P., Seenivasan, T., Livingston, E. H., Snell, P. G., Grundy, S. M., & Abate, N. (2007) · PLoS ONE · doi:10.1371/journal.pone.0000812 · Cited by 253 · see citing works
“In particular, it has been reported that visceral obesity may be an important contributing factor [4,7,8].”
BackgroundVikram, N., Pandey, R., Misra, A., Sharma, R., Devi, J. R., & Khanna, N. (2003) · Nutrition (Burbank, Los Angeles County, Calif.) · doi:10.1016/s0899-9007(02)01083-3 · Cited by 224 · see citing works
Araneta, M., & Barrett-Connor, E. (2005) · Obesity Research · doi:10.1038/oby.2005.176 · Cited by 221 · see citing works
Misra, A., Vikram, N., Arya, S., Pandey, R., Dhingra, V., Chatterjee, A., Dwivedi, M., Sharma, R., Luthra, K., Guleria, R., et al. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802704 · Cited by 221 · see citing works
Regional adiposity and insulin resistance.
Garg, A. (2004) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2004-0631 · Cited by 204 · see citing works
Current scenario of diabetes in India
Ramachandran, A., & Snehalatha, C. (2009) · Journal of Diabetes · doi:10.1111/j.1753-0407.2008.00004.x · Cited by 199
“Asian Indians develop diabetes at a younger age, at least 10–15 years earlier than the Caucasian population.47,48 The national urban diabetes survey in India showed that more than 50% of diabetic patients had onset at less than 50 years of age.24 Indians show a significantly higher age-related prevalence of diabetes c…”
BackgroundResultInfluentialSerum visfatin in relation to visceral fat, obesity, and type 2 diabetes mellitus in Asian Indians.
Sandeep, S., Velmurugan, K., Deepa, R., & Mohan, V. (2007) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2006.12.005 · Cited by 181 · see citing works
“Compared with Europeans, Asian Indians have increased visceral fat and central obesity despite lower generalized obesity, and this is referred to as the bAsian Indian phenotypeQ [1-4].”
BackgroundIs South Asian ethnicity an independent cardiovascular risk factor?
Gupta, M., Brister, S., & Verma, S. (2006) · Canadian Journal of Cardiology · doi:10.1016/s0828-282x(06)70895-9 · Cited by 180 · see citing works
“Accompanying the greater amount of abdominal fat is a higher degree of insulin resistance for the same BMI, a pattern that has been noted in nonobese South Asians as well (43).”
BackgroundVisceral and central abdominal fat and anthropometry in relation to diabetes in Asian Indians.
Anjana, M., Sandeep, S., Deepa, R., Vimaleswaran, K., Farooq, S., & Mohan, V. (2004) · Diabetes Care · doi:10.2337/diacare.27.12.2948 · Cited by 178 · see citing works
Heritabilities of the metabolic syndrome and its components in the Northern Manhattan Family Study
Lin, H.-F., Boden-Albala, B., Juo, S., Park, N., Rundek, T., & Sacco, R. (2005) · Diabetologia · doi:10.1007/s00125-005-1892-2 · Cited by 176 · see citing works
“The prevalence of the metabolic syndrome varies among ethnic groups [10–12].”
BackgroundMetabolic syndrome in South Asians
Pandit, K., Goswami, S., Ghosh, S., Mukhopadhyay, P., & Chowdhury, S. (2012) · Indian journal of endocrinology and metabolism · doi:10.4103/2230-8210.91187 · Cited by 175 · see citing works
“[77] Studies show that South Asians carry an increased risk and prevalence of hyperglycemia, dyslipidemia, and procoagulant tendency and have larger adipocytes (more insulin resistant).[14,30,78]”
International Journal of Diabetes in Developing Countries
Chandalia, H. (2013) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-012-0110-2 · Cited by 169 · see citing works
Diabetes and Associated Complications in the South Asian Population
Shah, A. D., & Kanaya, A. M. (2014) · Current Cardiology Reports · doi:10.1007/s11886-014-0476-5 · Cited by 188 · see citing works
Misra, A. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802412 · Cited by 167 · see citing works
Oka, R., Kobayashi, J., Yagi, K., Tanii, H., Miyamoto, S., Asano, A., Hagishita, T., Mori, M., Moriuchi, T., Kobayashi, M., et al. (2008) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2007.10.016 · Cited by 166 · see citing works
“[9] A.”
MethodMisra, R., Patel, T. G., Kotha, P., Raji, A., Ganda, O., Banerji, M., Shah, V. N., Vijay, K., Mudaliar, S., Iyer, D., et al. (2010) · Journal of diabetes and its complications · doi:10.1016/j.jdiacomp.2009.01.003 · Cited by 161 · see citing works
Self-citationDose-dependent effects of testosterone on regional adipose tissue distribution in healthy young men.
Woodhouse, L., Gupta, N., Bhasin, M., Singh, A. B., Ross, R., Phillips, J., & Bhasin, S. (2004) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2003-031492 · Cited by 159 · see citing works
IFSO-APC Consensus Statements 2011
Kasama, K., Mui, W., Lee, W.-J., Lakdawala, M., Naitoh, T., Seki, Y., Sasaki, A., Wakabayashi, G., Sasaki, I., Kawamura, I., et al. (2012) · Obesity Surgery · doi:10.1007/s11695-012-0610-7 · Cited by 157 · see citing works
“It has also been noted that for a given BMI, Asians have higher body fat percentage compared with Caucasians [21, 22].”
ResultAlcohol, adipose tissue and liver disease: mechanistic links and clinical considerations
Parker, R., Kim, S.-J., & Gao, B. (2017) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.116 · Cited by 173 · see citing works
Obesity epidemic in India: intrauterine origins?
Yajnik, C. S. (2004) · Proceedings of The Nutrition Society · doi:10.1079/pns2004365 · Cited by 138 · see citing works
“Studies in Pima Indians (Pettitt et al. 1983, 1988) and in Chicago, IL, USA (Silverman et al. 1995) have shown that maternal diabetes is a risk factor for both obesity and type 2 diabetes in the offspring.”
BackgroundInfluentialA Review and Assessment of Potential Sources of Ethnic Differences in Drug Responsiveness
Bjornsson, T., Wagner, J., Donahue, S., Harper, D., Karim, A., Khouri, M. S., Murphy, W. R., Roman, K., Schneck, D., Sonnichsen, D., et al. (2003) · Journal of clinical pharmacology · doi:10.1177/0091270003256065 · Cited by 150 · see citing works
Ethnicity and Type 2 diabetes in the UK
Goff, L. M. (2019) · Diabetic Medicine · doi:10.1111/dme.13895 · Cited by 146 · see citing works
Shah, A., Kandula, N., Lin, F., Allison, M., Carr, J., Herrington, D., Liu, K., & Kanaya, A. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.219 · Cited by 146 · see citing works
“Some studies conducted in the US have also found that compared to Whites, Asian Indians have higher levels of SAT and VAT for a given BMI (29, 30).”
BackgroundType‐2 diabetes: Current understanding and future perspectives
Pandey, A., Chawla, S., & Guchhait, P. (2015) · IUBMB Life · doi:10.1002/iub.1396 · Cited by 150 · see citing works
“In general, South Asians have a lower birth weight and are more insulin resistant than Europeans (28).”
BackgroundKanaya, A., Wassel, C. L., Mathur, D., Stewart, A., Herrington, D., Budoff, M., Ranpura, V., & Liu, K. (2010) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2009.0062 · Cited by 144 · see citing works
Coronary Artery Disease In Asian Indians: An Update And Review
Enas, E., & Senthilkumar, A. (2001) · The Internet Journal of Cardiology · doi:10.5580/5ba · Cited by 143 · see citing works
Reaven, G. (2005) · Diabetes and Vascular Disease Research · doi:10.3132/dvdr.2005.017 · Cited by 135 · see citing works
Oza‐Frank, R., Ali, M. K., Vaccarino, V., & Narayan, K. M. V. (2009) · Diabetes Care · doi:10.2337/dc09-0573 · Cited by 134 · see citing works
“For example, increased susceptibility to diabetes in Asian Indians compared with Europeans (7) despite lower BMIs (8) is attributed to central adiposity, which may be due to lifestyle and/or genetic/intrauterine pre-disposition.”
BackgroundKuriyan, R., Raj, T., Srinivas, S., Vaz, M., Rajendran, R., & Kurpad, A. (2007) · Appetite · doi:10.1016/j.appet.2006.09.013 · Cited by 134 · see citing works
Association of fruit and vegetable intake with cardiovascular risk factors in urban south Indians
Radhika, G., Sudha, V., Sathya, R. M., Ganesan, A., & Mohan, V. (2007) · British Journal Of Nutrition · doi:10.1017/s0007114507803965 · Cited by 110 · see citing works
Indulekha, K., Anjana, R., Surendar, J., & Mohan, V. (2011) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2010.12.015 · Cited by 123 · see citing works
Selection of measures in epidemiologic studies of the consequences of obesity
Stevens, J., McClain, J. E., & Truesdale, K. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.88 · Cited by 122 · see citing works
Gordura visceral, subcutânea ou intramuscular: onde está o problema?
Hermsdorff, H. H., & Monteiro, J. B. (2004) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302004000600005 · Cited by 114 · see citing works
Underweight and breast cancer recurrence and death: a report from the Korean Breast Cancer Society.
Moon, H., Han, W., & Noh, D. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2009.22.4436 · Cited by 113 · see citing works
Risk factors for diabetic retinopathy in self-reported rural population with diabetes.
Rani, P., Raman, R., Chandrakantan, A., Pal, S. S., Perumal, G., & Sharma, T. (2009) · Journal of Postgraduate Medicine · doi:10.4103/0022-3859.48787 · Cited by 111
“There are evidences that South Asians have abdominal obesity despite normal body mass indices, the so called “Asian Indian phenotype”; which may explain this paradox.[16]”
BackgroundThomas, E. L., & Bell, J. D. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.802229 · Cited by 111 · see citing works
Body fat, metabolic syndrome and hyperglycemia in South Asians.
Misra, A., Soares, M., Mohan, V., Anoop, S., Abhishek, V., Vaidya, R., & Pradeepa, R. (2018) · Journal of diabetes and its complications · doi:10.1016/j.jdiacomp.2018.08.001 · Cited by 109 · see citing works
Malavazos, A., Corsi, M., Ermetici, F., Coman, C., Sardanelli, F., Rossi, A., Morricone, L., & Ambrosi, B. (2007) · NMCD. Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2006.01.001 · Cited by 105 · see citing works
Raman, R., Rani, P., Gnanamoorthy, P., Sudhir, R., Kumaramanikavel, G., & Sharma, T. (2010) · Acta Diabetologica · doi:10.1007/s00592-009-0113-8 · Cited by 104 · see citing works
“what higher prevalence of type II diabetes, how obesity, general, abdominal or combined, influences diabetic retinopathy is not well documented [4].”
BackgroundLiew, C. F., Seah, E., Yeo, K.-P., Lee, K., & Wise, S. D. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802307 · Cited by 92 · see citing works
Kirkham, S., Akilen, R., Sharma, S., & Tsiami, A. (2009) · Diabetes, obesity and metabolism · doi:10.1111/j.1463-1326.2009.01094.x · Cited by 101 · see citing works
Body Composition in Asians and Caucasians
Haldar, S., Chia, S. C., & Henry, C. J. (2015) · Advances in Food and Nutrition Research · doi:10.1016/bs.afnr.2015.07.001 · Cited by 100 · see citing works
Prevalence, risk factors and complications associated with type 2 diabetes in migrant South Asians
Garduño-Diaz, S., & Khokhar, S. (2012) · Diabetes/Metabolism Research Reviews · doi:10.1002/dmrr.1219 · Cited by 100 · see citing works
“They tend to present high levels of LDL cholesterol, low levels of HDL cholesterol and high triglyceride concentrations, all recognized risk factors for T2D [115,116].”
BackgroundBouguerra, R., Alberti, H., Smida, H., Salem, L., Rayana, C., Atti, J. E., Achour, A., Gaigi, S., Slama, C., Zouari, B., et al. (2007) · Diabetes, obesity and metabolism · doi:10.1111/j.1463-1326.2006.00667.x · Cited by 100 · see citing works
Sohaei, S., Amani, R., Tarrahi, M. J., & Ghasemi-Tehrani, H. (2019) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2019.102201 · Cited by 100 · see citing works
Insulin Resistance and Vascular Dysfunction in Nondiabetic Asian Indians
Raji, A., Gerhard-Herman, M. D., Warren, M., Silverman, S. G., Raptopoulos, V., Mantzoros, C. S., & Simonson, D. C. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0087 · Cited by 98 · see citing works
“creased central obesity and visceral fat (6, 7).”
BackgroundResultInfluentialSelf-citationDiabetes and cardiovascular disease among asian indians in the united states
Mohanty, S., Woolhandler, S., Himmelstein, D., & Bor, D. (2005) · Journal of general internal medicine · doi:10.1111/j.1525-1497.2005.40294.x · Cited by 98 · see citing works
Radhika, G., Sathya, R., Ganesan, A., Saroja, R., Vijayalakshmi, P., Sudha, V., & Mohan, V. (2010) · Public Health Nutrition · doi:10.1017/s136898001000203x · Cited by 96 · see citing works
“This could particularly benefit Asian Indians, who have increased visceral fat and central obesity despite lower generalised obesity((36,37)).”
BackgroundAgrawal, S., Klarqvist, M., Diamant, N., Stanley, T., Ellinor, P., Mehta, N., Philippakis, A. A., Ng, K., Claussnitzer, M., Grinspoon, S., et al. (2023) · Nature Communications · doi:10.1038/s41467-022-35704-5 · Cited by 95 · see citing works
Goel, K., Misra, A., Vikram, N., Poddar, P., & Gupta, N. (2010) · Heart · doi:10.1136/hrt.2009.183236 · Cited by 93 · see citing works
“Another study comparing 12 Asian Indians living in the USA with 12 white Caucasians reported that, although both IAATand SCATwere significantly associated with insulin resistance, only IAAT correlated with triglyceride, LDLcholesterol and HDL-cholesterol levels.(26) However, these findings were not replicated in other…”
ResultBainey, K., & Jugdutt, B. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2008.09.023 · Cited by 93 · see citing works
“[78] Raji A, Seely EW, Arky RA, Simonson DC.”
BackgroundKalra, A., Nair, S., & Rai, L. (2006) · Indian Journal of Medical Sciences · doi:10.4103/0019-5359.27971 · Cited by 91 · see citing works
“Increased visceral fat has been observed in Asian Indians, which is not apparent from their BMI.”
InfluentialA cross-sectional investigation of regional patterns of diet and cardio-metabolic risk in India
Daniel, C., Prabhakaran, D., Kapur, K., Graubard, B., Devasenapathy, N., Ramakrishnan, L., George, P., Shetty, H., Ferrucci, L., Yurgalevitch, S., et al. (2011) · Nutrix Journal · doi:10.1186/1475-2891-10-12 · Cited by 90 · see citing works
“Abdominal adiposity, impaired glucose and lipid levels, as well as hypertension in a high-proportion of study participants corresponds with the high-risk “Asian Indian phenotype” that may be a product of genetic adaptations to food insecurity, fetal or early childhood malnutrition, as well as more recent environmental…”
BackgroundMohan, V., Deepa, M., Farooq, S., Narayan, K. M. V., Datta, M., & Deepa, R. (2007) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2007.02.009 · Cited by 90 · see citing works
“This is attributed to the so-called bAsian Indian phenotypeQ characterized by increased WC despite lower body mass indices, increased visceral fat [3], and greater insulin resistance [11].”
BackgroundGulati, S., & Misra, A. (2017) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2017.92 · Cited by 89 · see citing works
Lu, J., Bi, Y., Wang, T., Wang, W., Mu, Y., Zhao, J., Liu, C., Chen, L., Shi, L., Li, Q., et al. (2014) · International Journal of Cardiology · doi:10.1016/j.ijcard.2014.01.073 · Cited by 85 · see citing works
“Given that Asians have a unique phenotype characterized by relatively high abdominal obesity and tend to have high prevalence of cardiovascular risk factors even at low body mass index (BMI) [16–19], we hypothesize that both general and abdominal obesity are risk factors for cardiovascular diseases independent of insu…”
BackgroundThe abnormal lipid profile in obesity and coronary heart disease (CHD) in Pakistani subjects
Shabana, S., Shahid, S. U., & Sarwar, S. (2020) · Lipids in Health and Disease · doi:10.1186/s12944-020-01248-0 · Cited by 105 · see citing works
Hulmán, Á., Simmons, R. K., Brunner, E. J., Witte, D. R., Færch, K., Vistisen, D., Ikehara, S., Mika Kivimaki, B., & Tabák, Á. G. (2017) · Diabetologia · doi:10.1007/s00125-017-4275-6 · Cited by 103 · see citing works
Adipose tissue, metabolic syndrome and polycystic ovary syndrome: from pathophysiology to treatment.
Garruti, G., Depalo, R., Vita, M. G., Lorusso, F., Giampetruzzi, F., Damato, A., & Giorgino, F. (2009) · Reproductive Biomedicine Online · doi:10.1016/j.rbmo.2009.05.010 · Cited by 83 · see citing works
“However, excess intraperitoneal fat is more strongly correlated with insulin resistance and type-2 diabetes than subcutaneous or retroperitoneal adipose tissue (Abate et al., 1995; Goodpaster et al., 1997; Brochu et al., 2000; Kelley et al., 2000; Raji et al., 2001; Ross et al., 2002; Nielsen et al., 2004).”
BackgroundWasir, J., & Misra, A. (2004) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2004.2.14 · Cited by 83
Retnakaran, R., Hanley, A., Connelly, P., Sermer, M., & Zinman, B. (2006) · Journal of Clinical Endocrinology and Metabolism · doi:10.1210/jc.2005-1253 · Cited by 83 · see citing works
“One explanation for this observation is that South Asians exhibit increased visceral obesity compared with other ethnic groups at similar BMI (18).”
BackgroundSociodemographic risk factors associated with metabolic syndrome in a Mediterranean population
Buckland, G., Salas-Salvadó, J., Roure, E., Bulló, M., & Serra-Majem, L. (2008) · Public Health Nutrition · doi:10.1017/s1368980008003492 · Cited by 80 · see citing works
“When individuals with the same BMI and age but different body fat distributions are compared, those with central body fat have a greater risk of insulin resistance((41)).”
Type 2 diabetes in South Asians: A pathophysiologic focus on the Asian-Indian epidemic
Bajaj, M., & Banerji, M. A. (2004) · Current Diabetes Reports · doi:10.1007/s11892-004-0026-4 · Cited by 83 · see citing works
- Authors
- Raji, A., Seely, E. W., Arky, R. A., & Simonson, D. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Raji, Annaswamy
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2001-11
- Volume
- 86
- Issue
- 11
- Pages
- 5366-5371
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2036168461
- Cited by
- 541
- References
- 0
- Citations by year
- 2026: 4 · 2025: 16 · 2024: 14 · 2023: 19 · 2022: 15 · 2021: 20 · 2020: 22 · 2019: 23 · 2018: 24 · 2017: 28 · 2016: 25 · 2015: 31 · 2014: 27 · 2013: 35 · 2012: 33
- FWCI
- 6.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- 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 › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- insulin resistance, body fat distribution, visceral fat, Asian Indians, Caucasians, ethnic differences, hyperinsulinemia, glucose disposal rate, plasminogen activator inhibitor-1, dyslipidemia, abdominal fat, cardiovascular risk, diabetes risk
- MeSH terms
- Adipose Tissue, Adult, Aged, Blood Glucose, Female, Glucose Tolerance Test, Humans, India, Insulin Resistance, Lipids, Male, Middle Aged, Reference Values, Tomography, X-Ray Computed, Glucose Clamp Technique, Body Mass Index, Plasminogen Activator Inhibitor 1, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
