ObjectiveSouth Asians are susceptible to insulin resistance even without obesity. We examined the characteristics of body fat content, distribution and function in South Asian men and their relationships to insulin resistance compared to Caucasians.Research Design and MethodsTwenty-nine South Asian and 18 Caucasian non-diabetic men (age 27±3 and 27±3 years, respectively) underwent euglycemic-hyperinsulinemic clamp for insulin sensitivity, underwater weighing for total body fat, MRI of entire abdomen for intraperitoneal (IP) and subcutaneous abdominal (SA) fat and biopsy of SA fat for adipocyte size.ResultsCompared to Caucasians, in spite of similar BMI, South Asians had higher total body fat (22±6 and 15±4% of body weight; p-value<0.0001), higher SA fat (3.5±1.9 and 2.2±1.3 kg, respectively; p-value = 0.004), but no differences in IP fat (1.0±0.5 and 1.0±0.7 kg, respectively; p-value = 0.4). SA adipocyte cell size was significantly higher in South Asians (3491±1393 and 1648±864 µm2; p-value = 0.0001) and was inversely correlated with both glucose disposal rate (r-value = −0.57; p-value = 0.0008) and plasma adiponectin concentrations (r-value = −0.71; p-value<0.0001). Adipocyte size differences persisted even when SA was matched between South Asians and Caucasians.ConclusionsInsulin resistance in young South Asian men can be observed even without increase in IP fat mass and is related to large SA adipocytes size. Hence ethnic excess in insulin resistance in South Asians appears to be related more to excess truncal fat and dysfunctional adipose tissue than to excess visceral fat.

Background: Oxidative stress and inflammation are crucial in atherogenesis. ␣-Tocopherol is both an antioxidant and an antiinflammatory agent. Objective: We evaluated the effect of RRR-␣-tocopherol supplementation on carotid atherosclerosis in patients with stable coronary artery disease (CAD) on drug therapy. Design: Randomized, controlled, double-blind trial compared RRR-␣-tocopherol (1200 IU/d for 2 y) with placebo in 90 patients with CAD. Intimal medial thickness (IMT) of both carotid arteries was measured by high-resolution B-mode ultrasonography at 0, 1, 1.5, and 2 y. At 6-mo intervals, plasma ␣-tocopherol concentrations, C-reactive protein (CRP), LDL oxidation, monocyte function (superoxide anion release, cytokine release, and adhesion to endothelium), and urinary F 2 -isoprostanes were measured. Results: ␣-Tocopherol concentrations were significantly higher in the ␣-tocopherol group but not in the placebo group. Highsensitivity CRP concentrations were significantly lowered with ␣-tocopherol supplementation than with placebo (32%; P 0.001). ␣-Tocopherol supplementation significantly reduced urinary F 2 -isoprostanes (P 0.001) and monocyte superoxide anion and tumor necrosis factor release compared with baseline and placebo (P 0.001). No significant difference was observed in the mean change in total carotid IMT in the placebo and ␣-tocopherol groups. In addition, no significant difference in cardiovascular events was observed (P ҃ 0.21). Conclusions: High-dose RRR-␣-tocopherol supplementation in patients with CAD was safe and significantly reduced plasma biomarkers of oxidative stress and inflammation but had no significant effect on carotid IMT during 2 y.Am J Clin Nutr 2007;86:1392-8.