Cited by 541Diabetes, Cardiovascular Risks, and LipoproteinsAdipokines, Inflammation, and Metabolic DiseasesBody Composition Measurement Techniques

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Body Fat Distribution and Insulin Resistance in Healthy Asian Indians and Caucasians

Raji, Annaswamy, Seely, Ellen W., Arky, Ronald A., Simonson, Donald C.·2001·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jcem.86.11.7992

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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.

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Influential
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SREBP-2 1784 G/C Genotype is Associated with Non-Alcoholic Fatty Liver Disease in North Indians
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“TheCallele and theG/C genotype of SREBP-2 1784 G > C is associated with increased risk of NAFLD in Asian Indians residing in north India and should be evaluated further in future prospective studies.”
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Lifestyle Interventions and the Prevention and Treatment of Type 2 Diabetes
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Abdominal visceral fat accumulation is associated with the results of 123I-metaiodobenzylguanidine myocardial scintigraphy in type 2 diabetic patients
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Shahi, A., Tripathi, D., Jain, M., Jadon, R., Sethi, P., Khadgawat, R., Khan, M., Madhusudan, K. S., Prakash, S., & Vikram, N. (2023) · Diabetes & metabolic syndrome · doi:10.1016/j.dsx.2023.102902 · Cited by 14
The impact of the Sri Lankan economic crisis on medication adherence: An online cross-sectional survey
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Distinct opposing associations of upper and lower body fat depots with metabolic and cardiovascular disease risk markers
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Alterations in Autophagy and Mammalian Target of Rapamycin (mTOR) Pathways Mediate Sarcopenia in Patients with Cirrhosis.
Anand, A., Nambirajan, A., Kumar, V., Agarwal, S., Sharma, S., Mohta, S., Gopi, S., Kaushal, K., Gunjan, D., Singh, N., et al. (2021) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2021.05.004 · Cited by 14
Adiposity and Cardiovascular Risk Clustering in South Asians
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Non-alcoholic fatty liver disease among visitors to a hepatitis awareness programme.
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Performance of waist circumference relative to BMI in predicting risk of obesity and hypertension among affluent Indian adults
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“However, several studies have shown that Asians have higher amounts of body fat, especially abdominal or truncal S. Rao, P. Parab-Waingankar / Health 5 (2013) 16-22 20 Women 209 0.64** (0.55 - 0.73) 66.7 50.1 0.76 *p < 0.05; **p < 0.01; n.s: Non Significant; aROC: Receiver operating characteristic analysis; bBMI: Body…”
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CARDIOVASCULAR COMORBIDITIY IN PSORIASIS
Singh, G., & Aneja, S. (2011) · Indian Journal of Dermatology · doi:10.4103/0019-5154.87154 · Cited by 14
“[35] Patients with severe psoriasis have a higher BMI that is directly related to the risk of cardiovascular mortality.”
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Correlations of visceral fat accumulation and atherosclerosis in Japanese patients with type 2 diabetes mellitus
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Combination of gemfibrozil and orlistat for treatment of combined hyperlipidemia with predominant hypertriglyceridemia.
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Androgen Deprivation Therapy and the Re-emergence of Parenteral Estrogen in Prostate Cancer
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Obesity, abdominal obesity, and adipose tissue depots in South Asians with specific reference to Asian Indians: Implications of New Obesity Guidelines
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Non-alcoholic fatty liver disease: A real threat in Pakistan.
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“are contributed by increased abdominal and visceral fat.[7] 52 The adult prevalence rate of obesity is estimated to be 8% (6% in males and 53 10% in females), and the adolescent prevalence rate is 3% in Pakistan according 54 to WHO.”
Background
Visceral Fat Accumulation Is Associated with Asthma in Patients with Type 2 Diabetes
Murakami, D., Anan, F., Masaki, T., Umeno, Y., Shigenaga, T., Eshima, N., & Nakagawa, T. (2019) · Journal of Diabetes Research · doi:10.1155/2019/3129286 · Cited by 13
“VFA is a risk factor for cardiovascular disease [12] and is associated with insulin resistance in healthy individuals [13] and patients with type 2 diabetes mellitus [14].”
Background
Contribution of classical and emerging risk factors to coronary artery disease in Asian Indians
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Is vulnerability to cardiometabolic disease in Indians mediated by abdominal adiposity or higher body adiposity
Kuper, H., Taylor, A., Krishna, K. R., Ben-Shlomo, Y., Gupta, R., Kulkarni, B., Prabhakaran, D., Smith, G. D., Wells, J., Ebrahim, S., et al. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-1239 · Cited by 13
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BackgroundInfluential
Effects of Valsartan Versus Amlodipine in Diabetic Hypertensive Patients With or Without Previous Cardiovascular Disease
Yamashita, K., Kondo, T., Muramatsu, T., Matsushita, K., Nagahiro, T., Maeda, K., Shintani, S., & Murohara, T. (2013) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2013.07.043 · Cited by 15
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“Since then, it has been shown that South Asians have a different adipokine profile than Caucasians, with lower adiponectin and higher leptin,(20) and different anthropometrics with reduced lean body mass and greater visceral adiposity which is proportionately related to insulin resistance.(21,22) This was quantitated…”
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Change in Body Compositions of Asian Recipients after Kidney Transplantation
Han, S., Hwang, J., Oh, Y., Cha, R.-H., Ahn, C., & Kim, Y. S. (2012) · Journal of Korean medical science · doi:10.3346/jkms.2012.27.10.1182 · Cited by 13
“Above all, it is well known that body fat accumulation and distribution differ according to race (29, 30).”
Background
Upper-normal waist circumference is a risk marker for metabolic syndrome in normal-weight subjects.
Okada, R., Yasuda, Y., Tsushita, K., Wakai, K., Hamajima, N., & Matsuo, S. (2016) · NMCD. Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2015.10.001 · Cited by 13
Individualised prescription of medications for treatment of obesity in adults
HOCKING, S. L., & Sumithran, P. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09808-2 · Cited by 12
“When compared to White Europeans of the same BMI, Asians have 3 – 5% higher body fat [13], and South Asians in particular are more prone to develop abdominal obesity [14].”
Background
Obesity and Cardiovascular Risk Among South Asian Americans
Deshpande, A., Shah, N. S., & Kandula, N. R. (2023) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-023-00714-5 · Cited by 15
Increasing prevalence of gestational diabetes mellitus when carrying the T variant allele of the MTHFR gene C677T polymorphism: a systematic review and meta-analysis
Chen, Y., Lu, M., Nie, J., Liu, J., Liu, Y., Ye, M., Sun, X., Ji, C., Zhang, J., & Yang, X. (2021) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-021-06303-4 · Cited by 12
High prevalence of insulin resistance and occurrence prior to hyperinsulinemia threshold among people living with HIV in Pune, India
Marbaniang, I., Sangle, S. A., Salvi, S., Kulkarni, V., Shere, D., Deshpande, P., Nimkar, S., Gupta, A., & Mave, V. (2019) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2019.04.009 · Cited by 11
Plasma Free Fatty Acids Metabolic Profile with LC-MS and Appetite-Related Hormones in South Asian and White European Men in Relation to Adiposity, Physical Activity and Cardiorespiratory Fitness: A Cross-Sectional Study
Benedetti, S., Al‐Tannak, N. F., Alzharani, M. A., Moir, H. J., Stensel, D. J., Thackray, A. E., Naughton, D. P., Dorak, M. T., Spendiff, O., Hill, N. J., et al. (2019) · Metabolites · doi:10.3390/metabo9040071 · Cited by 12
“In support of previous findings, higher fasting insulin and elevated glucose and insulin OGTT concentrations were also observed in South Asian participants compared with white European men [32,33] which are indicative of a greater degree of insulin resistance.”
Result
Adiposity measures and their validity in estimating risk of hypertension in South Asian children: a cross-sectional study
Fowokan, A., Punthakee, Z., Waddell, C., Rosin, M. P., Morrison, K. M., Gupta, M., Teo, K. K., Rangarajan, S., & Lear, S. A. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024087 · Cited by 15
IndEcho study: cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of midlife myocardial structure and function in South Asians
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Impact of lifestyle intervention in primary prevention of Type 2 diabetes did not differ by baseline age and BMI among Asian‐Indian people with impaired glucose tolerance
Nanditha, A., Snehalatha, C., Ram, J., Selvam, S., Vijaya, L., Shetty, S., Arun, R., & Ramachandran, A. (2016) · Diabetic Medicine · doi:10.1111/dme.13071 · Cited by 10
Body Fat Distribution and Adipokine Secretion Are Not Associated with Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus
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General Public’s knowledge, awareness, and perception of Cardiometabolic diseases: data from a Singapore study population
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“In contrast to Western populations, there is a higher prevalence of metabolic dysfunction at relatively lower levels of obesity in Asian populations, which makes the identification and management of these silent metabolic disorders even more challenging (7–10).”
BackgroundInfluential
Relationship between obesity and coronary heart disease among urban Bangladeshi men and women
Khan, R., Harvey, D., Leistikow, B., Haque, K., & Stewart, C. (2015) · Integrative Obesity and Diabetes · doi:10.15761/iod.1000112 · Cited by 11
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Genetics of Type 2 Diabetes: Advances and Future Prospect
Singh, S. (2015) · Journal of Diabetes & Metabolism · doi:10.4172/2155-6156.1000518 · Cited by 5
“Also, Asian Indians are more susceptible to developing truncal obesity, which might account for their tendency to insulin resistance referred to as “Asian Indian phenotype” [81-85].”
Background

Authors: Raji, A., Seely, E. W., Arky, R. A., & Simonson, D. C.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Raji, Annaswamy
ORCID: Raji, Annaswamy
Seely, Ellen W.
Simonson, Donald C.
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
DOI: 10.1210/jcem.86.11.7992
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 › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Physiology (medical) › 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

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Body Fat Distribution and Insulin Resistance in Healthy Asian Indians and Caucasians

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