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Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study
Abstract
The etiology of NIDDM is still controversial, with both insulin resistance and decreased insulin secretion postulated as potential important factors. African-Americans and Hispanics have a two- to threefold excess risk of developing NIDDM compared with non-Hispanic whites. Yet little is known concerning the prevalence of insulin resistance and secretion defects in minorities, especially in African-Americans in population-based studies. Fasting and 2-h post-glucose load glucose and insulin levels, insulin-mediated glucose disposal (insulin sensitivity index) (S(I)), glucose effectiveness (S(G)), and first-phase insulin response (acute insulin response [AIR]) were determined in nondiabetic African-Americans (n= 288), Hispanics (n= 363), and non-Hispanic whites (n= 435) as part of the Insulin Resistance Atherosclerosis Study. Subjects received a standard 2-h oral glucose tolerance test on the first day and an insulin-modified frequently sampled intravenous glucose tolerance test on the second day. African-Americans and Hispanics were more obese than non-Hispanic whites. Both African-Americans and Hispanics had higher fasting and 2-h insulin concentrations and AIR but lower S(I) than non-Hispanic whites. No ethnic difference was observed in S(G). After further adjustments for obesity, body fat distribution, and behavioral factors, African-Americans continued to have higher fasting and 2-h insulin levels and AIR, but lower S(I) than non-Hispanic whites. In contrast, after adjustment for these covariates, no significant ethnic differences in S(I) or fasting insulin levels were observed between Hispanics and non-Hispanic whites. Hispanics continued to have higher 2-h insulin levels and AIRs than those in non-Hispanic whites. In this report, the association between S(I) and upper body adiposity (waist-to-hip, ratio) was similar in each ethnic group. Both nondiabetic African-Americans and Hispanics have increased insulin resistance and higher AIR than nondiabetic non-Hispanic whites, suggesting that greater insulin resistance may be in large part responsible for the higher prevalence of NIDDM in these minority groups. However, in Hispanics. the greater insulin resistance may be due to greater adiposity and other behavioral factors.
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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 [20]
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McHugh, B. C. (2016) · Journal of International Crisis and Risk Communication Research
Cardiac Autonomic Control in Patients with Metabolic Syndrome
Mitchell, J. C. (2016) · Journal of International Crisis and Risk Communication Research
Metadata
- Authors
- 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., & Bergman, R. N.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Department of Public Health Sciences, Bowman Gray School of Medicine Winston-Salem, North Carolina
- University of Southern California (US)
- University of Colorado Anschutz (US)
- Department of Medicine, University of Texas Health Science Center at San Antonio San Antonio, Texas
- Kaiser Permanente (US)
- Atrium Health Wake Forest Baptist (US)
- National Institutes of Health (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 1996-06-01
- Volume
- 45
- Issue
- 6
- Pages
- 742-748
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- OpenAlex
- W2121083878
- Cited by
- 536
- References
- 0
- Citations by year
- 2026: 2 · 2025: 12 · 2024: 5 · 2023: 9 · 2022: 18 · 2021: 15 · 2020: 19 · 2019: 17 · 2018: 17 · 2017: 16 · 2016: 23 · 2015: 15 · 2014: 20 · 2013: 18 · 2012: 23
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01hl047890-09, 5u01hl047887-09, 5u01hl047889-09)
- National Heart, Lung, and Blood Institute (HL-47889, HL‐47890, HL47887)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- insulin resistance, insulin secretion, type 2 diabetes, African Americans, Hispanic Americans, ethnic differences, insulin sensitivity index, acute insulin response, glucose effectiveness, obesity, Insulin Resistance Atherosclerosis Study
- MeSH terms
- Insulin Secretion, Africa, Analysis of Variance, Arteriosclerosis, Black or African American, Blood Glucose, Cross-Sectional Studies, Diet, Female, Glucose Tolerance Test, Hispanic or Latino, Humans, Insulin, Insulin Resistance, Male, Mexico, Middle Aged, United States, Black People, White People
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