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Contribution of Insulin Secretion and Clearance to Glucose-Induced Insulin Concentration in African-American and Caucasian Children
Abstract
Relative to Caucasians (C), African-American (AA) children and adults have lower indices of insulin sensitivity (S(i)) and a higher acute insulin response to glucose (AIR(g)). Among AA children, AIR(g) is greater than that which would be predicted based on lower S(i). The objectives of the present study were 1) to determine whether insulin secretory parameters differ in AA vs. C children and adolescents using C-peptide modeling, 2) to determine whether hepatic insulin extraction differs with ethnicity/race using the C-peptide to insulin molar ratio, and 3) to determine whether the relatively greater AIR(g) among African-Americans is due to greater insulin secretion or lesser clearance. Subjects (n = 76) were AA and C children (mean age, approximately 11 yr). A 3-h tolbutamide-modified iv glucose tolerance test and minimal modeling were used to determine S(i) and AIR(g). First phase C-peptide/insulin secretion and basal, first, and second phase beta-cell sensitivity to glucose were determined using C-peptide modeling with standard kinetic parameters developed in adults. The incremental C-peptide to insulin molar ratio over the 3-h test period, an index of hepatic insulin extraction, was calculated with the trapezoidal method. S(i) was lower and AIR(g) was higher in AA vs. C children. First phase C-peptide/insulin secretion and first phase beta-cell sensitivity to glucose were approximately 2-fold greater in AA vs. C children (P < 0.001); there were no between-group differences in basal or second phase beta-cell sensitivity to glucose. Hepatic insulin extraction was lower in AA vs. C (3.77 +/- 1.78% vs. 5.99 +/- 2.18%; P < 0.001). Multiple linear regression modeling indicated that first phase C-peptide/insulin secretion and hepatic insulin extraction contributed independently to AIR(g); however, it was only first phase C-peptide/insulin secretion that explained the significant independent contribution of ethnicity/race to AIR(g) after adjusting for S(i). The results of this study suggest that greater AIR(g) among AA is due to both greater insulin secretion and lesser hepatic insulin extraction, and that AIR(g) above that predicted based on lower S(i) is due to greater insulin secretion. The insulin secretion data await verification that the kinetic parameters used apply to children and AA.
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“African Americans (AAs), Mexican Americans, and Native Americans secrete a greater amount of insulin than do European Americans (EAs) for a given amount of exposure to oral or intravenous glucose (19)(20)(21).”
From A Lower-Carbohydrate, Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes (2015) · cites this paper as [19]
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- Gower, 2000, Immunoreactive insulin, specific insulin, and proinsulin in African-American and Caucasian children, Diabetes, 49, A297
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Self-citationINTESTINAL PEPTIDES AND ETHNIC DIFFERENCES IN INSULIN SECRETION
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β-cell function in black South African women: Associations with insulin clearance and ectopic fatPreprint
Smidt, M. F., Mendham, A., Hauksson, J., Alhamud, A., Stefanovski, D., Hakim, O., Swart, J., Goff, L., Kahn, S., Olsson, T., et al. (2020) · doi:10.21203/rs.3.rs-35455/v1
β-cell function in black South African women: Associations with insulin clearance and ectopic fatPreprint
Smidt, M. F.-D., Mendham, A. E., Hauksson, J. B., Alhamud, A., Stefanovski, D., Hakim, O., Swart, J., Goff, L. M., Kahn, S. E., Olsson, T., et al. (2020) · doi:10.21203/rs.3.rs-35455/v2
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Metadata
- Authors
- Gower, B. A., Granger, W. M., Franklin, F., Shewchuk, R. M., & Goran, M. I.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Gower, Barbara A.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2002-05-01
- Volume
- 87
- Issue
- 5
- Pages
- 2218-2224
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2152805454
- Cited by
- 114
- References
- 32
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 9 · 2019: 4 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 5
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsches Krebsforschungszentrum
- National Institutes of Health (5r01hl033064-05, 5r29hd032668-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058278, R01 DK58278, P30-DK56336, P30DK056336)
- National Center for Research Resources (M01RR00032, M01RR000032)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R29-HD-32668, R01 HD/HL-33064)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin secretion, insulin clearance, hepatic insulin extraction, acute insulin response to glucose, insulin sensitivity, first-phase insulin secretion, racial differences, African American children, children and adolescents, glucose tolerance test
- MeSH terms
- Insulin Secretion, Adolescent, Black or African American, C-Peptide, Child, Female, Glucose, Glucose Tolerance Test, Humans, Insulin, Liver, Male, Osmolar Concentration, Regression Analysis, Black People, White People
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