Dysregulated lipid storage and its relationship with insulin resistance and cardiovascular risk factors in non-obese Asian patients with type 2 diabetes

Abstract

The prevalence of non-obese type 2 diabetes in Asians is up to 50%. This review aims to summarize the role of regional fat in the development of insulin resistance and cardiovascular risk in non-obese Asian type 2 diabetes as well as the role of intra-pancreatic fat and β-cell dysfunction. The body fat content of non-obese Asian type 2 diabetic patients is not different from that of non-diabetic subjects but the proportion of intra-abdominal and intra-hepatic fat are greater. Visceral fat contributes to insulin resistance and cardiovascular risk in non-obese Asian type 2 diabetes. Intra-hepatic fat and the hypertrophic abdominal subcutaneous adipocytes are associated with insulin resistance and cardiovascular risk in non-obese, non-diabetic Asian subjects. It may be true in non-obese Asian type 2 diabetic patients. The role of intra-myocellular lipid and insulin resistance is uncertain. Intra-pancreatic fat may not be involved in β-cell dysfunction in non-obese Asian type 2 diabetes.

Fatty Liver, and Not Visceral Fat, Is More Associated with Liver Fibrosis and Diabetes in Non-Obese Japanese Individuals: A Cross-Sectional Study

“…The so-called lean NAFLD (BMI, Caucasians ≤ 25 kg/m 2 ; Asian ≤ 23 kg/m 2 ) has been diagnosed in 10-20% of non-obese Asians with NAFLD [6,7] Asians are known to be more susceptible to BMI-related metabolic disorders compared with Westerners. In non-obese Asians, as in other ethnic groups, visceral fat accumulation (VFA) and fatty liver (FL) are reported to be associated with insulin resistance and metabolic abnormalities [8][9][10][11][12][13]. Metabolically obese, normal-weight Asians have 20-30% lesser insulin sensitivity and 30-40% higher fasting and postprandial insulin secretion than metabolically healthy, lean controls [14] Among Japanese men with BMI of 23-25 kg/m 2 , those with hypertension, hyperglycemia, or dyslipidemia have insulin resistance in the liver but less insulin resistance in the muscle.…”

Evidence of higher intramyocellular fat among normal and overweight Indians with prediabetes

“…A relationship between IMCL and insulin resistance, though demonstrated in Caucasians, has not been established among Asians with Type 2 Diabetes [12,13]. In addition there is little information about IMCL among normal and overweight resident Indians, particularly those with prediabetes.…”

The role of the gut microbiota in the regulation of incretin effects

“…Відомо, що ЦД 2-го типу виникає на підґрунті інсулінорезистентності (ІР) периферичних тканин і супроводжується множинними гормональними та метаболічними порушеннями. Встановлено, що характерною для ЦД 2-го типу є ентероендокринна дисфункція, зокрема зниження активності глюкагоноподібного пептиду-1 (ГПП-1) -ентерогормону групи інкретинів, який виділяють клітини кишечнику у відповідь на прийом їжі та регулюють вивільнення панкреатичних гормонів і ферментів [1,2].…”