Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites. The Insulin Resistance Atherosclerosis Study

Sm, Haffner; D’Agostino, Ralph B.; Saad, Mohammad F.; Rewers, M.; Mykkänen, Leena; Selby, Joseph V.; Howard, G.; Savage, Peter J.; Hamman, Richard F.; Wagenknecht, Lynne E.; al, et

doi:10.2337/diabetes.45.6.742

Cited by 265 publications

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“…18,43 Blacks of African origin are prone to hypertension when they gain weight, they also appear to be susceptible to type 2 diabetes. 44,45 Native Americans and Hispanics are especially susceptible to type 2 diabetes, but are less likely to develop hypertension than are blacks. 23,[43][44][45] Our analysis also revealed the ethnic variation in prevalence of the different components used to define the syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…44,45 Native Americans and Hispanics are especially susceptible to type 2 diabetes, but are less likely to develop hypertension than are blacks. 23,[43][44][45] Our analysis also revealed the ethnic variation in prevalence of the different components used to define the syndrome. Generally, compared with non-Aboriginal people, Native Indians had a worse metabolic profile with high rates of abdominal obesity and hyperglycemia, and Inuit had a better metabolic profile except for a high rate of abdominal obesity.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada

et al. 2005

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Objective: To compare the characteristics and prevalence of the metabolic syndrome (MetS) among Native Indians, Inuit, and non-Aboriginal Canadians. Methods: The study was based on four cross-sectional studies conducted in the late 1980s and early 1990s involving three ethnic groups living in contiguous regions in central Canada: Oji-Cree Indians from several reserves in northern Ontario and Manitoba, Inuit from the Keewatin region of the Northwest Territories, and non-Aboriginal Canadians (predominantly of European heritage) in the province of Manitoba. The MetS was identified among adult subjects according to the National Cholesterol Education Program (NCEP) definition. Prevalence rates were standardized to the 1991 Canadian national population. Results: The age-standardized prevalence of the MetS varied by ethnic group, ranging from as high as 45% among Native Indian women to as low as 8% among Inuit men. Compared with Canadians of European origin, Indians had a worse metabolic profile, while Inuit had a better metabolic profile except for a high rate of abdominal obesity. The NCEP criteria in identifying individuals with the MetS were compared to those of the World Health Organization (WHO) in a subset of subjects with the requisite laboratory data. There was moderate agreement between the NCEP and WHO definitions, with a kappa value of 0.63 (95% confidence interval 0.56-0.70). Conclusions:The results indicate that the MetS is prevalent in diverse ethnic groups in Canada but varies in the pattern of phenotypic expression. Given the diverse nature of these populations, careful consideration should be given to developing culturally appropriate community-based prevention strategies aimed at reducing the frequency of this syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada

et al. 2005

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“…Interestingly, epidemiological studies of cardiovascular risk factors have suggested that Hispanics are frequently more obese and insulin resistant compared with non-Hispanic whites (NHWs) and often, as a result, have higher triglyceride levels and lower HDL cholesterol levels (5)(6)(7)(8)(9)(10)(11)(12)(13). This apparent decreased rate of cardiovascular disease (CVD) in Hispanics, despite evidence of increased levels of several traditional and nontraditional risk factors, has been described as the "Hispanic paradox" (14,15).…”

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confidence: 99%

Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

Reaven¹,

Sacks²

2004

Diabetes Care

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OBJECTIVE -To compare lifestyle factors, cardiovascular risk factors, and coronary artery calcium (CAC) and abdominal aortic calcium (AAC) levels in Hispanic and non-Hispanic white (NHW) individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS -We recently demonstrated in a small group of nonreferred, healthy, nondiabetic subjects that CAC was reduced in Hispanics compared with NHWs, despite a worse cardiovascular risk factor profile. In this study, we evaluated whether this ethnic disparity in vascular calcification was present in individuals with type 2 diabetes and in several different arterial beds. Hispanic and NHW subjects (n ϭ 245) with type 2 diabetes were evaluated for cardiovascular risk factors using questionnaires and assays of plasma biomarkers. CAC and AAC were measured by electron-beam computer-assisted tomography.RESULTS -Although Hispanics were slightly younger than NHWs, other standard risk factors and novel cardiovascular risk factors, including plasminogen activator-1 and fibrinogen levels, were similar between the groups. Despite the similar risk factor profile, the prevalence of cardiovascular disease (CVD) and mean and median levels of CAC and AAC were lower in Hispanics. Furthermore, the distribution of these calcium scores differed from that of NHWs (P Ͻ 0.05), with significantly fewer Hispanic subjects having high CAC or AAC scores. These differences were not explained by differences in CVD prevalence or any measured lifestyle or risk factor.CONCLUSIONS -Hispanics with type 2 diabetes have reduced CAC and AAC levels compared with NHW subjects, suggesting a reduction in the overall burden of vascular calcification and atherosclerosis. These data are consistent with the notion that Hispanics are protected against the development of CVD. Diabetes Care 27:1115-1120, 2004N umerous studies over the past several decades, using vital statistics data, have demonstrated reduced rates of total and cardiovascular mortality in Hispanics (1-4). Interestingly, epidemiological studies of cardiovascular risk factors have suggested that Hispanics are frequently more obese and insulin resistant compared with non-Hispanic whites (NHWs) and often, as a result, have higher triglyceride levels and lower HDL cholesterol levels (5-13). This apparent decreased rate of cardiovascular disease (CVD) in Hispanics, despite evidence of increased levels of several traditional and nontraditional risk factors, has been described as the "Hispanic paradox" (14,15). However, in several recent longitudinal cohort studies, rates of CVD have appeared equal or possibly greater in Hispanics compared with their NHW counterparts (16 -20). It is important to note that in several of these studies, the comparison between ethnic groups may have been complicated by the greater prevalence and incidence of diabetes in the Hispanic population, which may greatly enhance the overall cardiovascular risk of this ethnic group in comparison with groups having reduced rates of diabetes.To further assess this potential ethnic disparity in th...

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“…The Mexican American population is characterized by increased adiposity [1][2][3][4]6], a more centralized distribution of body fat [6,7], hyperinsulinaemia [8][9][10] and insulin resistance [11,12].Metabolic factors have been shown to be important risk factors for the development of NIDDM. Both insulin resistance [13,14] and hyperinsulinaemia [13,[15][16][17][18][19] have been shown to predict NIDDM.…”

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confidence: 99%

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confidence: 99%

Are risk factors for conversion to NIDDM similar in high and low risk populations?

1997

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Numerous studies have shown that Mexican Americans have an increased prevalence [1][2][3][4] and incidence [5] of non-insulin-dependent diabetes mellitus (NIDDM) relative to non-Hispanic whites. The Mexican American population is characterized by increased adiposity [1][2][3][4]6], a more centralized distribution of body fat [6,7], hyperinsulinaemia [8][9][10] and insulin resistance [11,12].Metabolic factors have been shown to be important risk factors for the development of NIDDM. Both insulin resistance [13,14] and hyperinsulinaemia [13,[15][16][17][18][19] have been shown to predict NIDDM. Likewise, decreased insulin secretion in response to various stimuli may predict NIDDM. A low acute insulin response has been found to predict NIDDM in Pima Indians [13], but not in children of two Caucasian diabetic parents [14]. A low 30-min increment in insulin relative to the 30-min increment in glucose (DI 30 /DG 30 ) during an oral glucose tolerance test predicts conversion to NIDDM, especially in subjects with impaired glucose tolerance [20][21][22][23]. A low insulin response 60 min after an intravenous glucose challenge also predicted NIDDM [24,25]. A low 2-h insulin in response to an oral glucose load also Diabetologia (1997) 40: 62-66 Are risk factors for conversion to NIDDM similar in high and low risk populations? Summary Mexican Americans have an increased risk of non-insulin-dependent diabetes mellitus (NIDDM) relative to non-Hispanic whites which is only partially explained by their excess overall obesity and unfavourable body fat distribution. Non-diabetic Mexican Americans have hyperinsulinaemia and insulin resistance relative to non-Hispanic whites. We therefore hypothesized that the insulin resistance might be a more important predictor of NIDDM in high-risk populations characterized by obesity and insulin resistance, while compromised insulin secretion might be a more important risk factor for NIDDM in low-risk populations. We assessed the ability of ethnicity (Mexican American vs non-Hispanic white), age, overall adiposity (body mass index [BMI]), unfavourable body fat distribution (as assessed by waist-to-hip ratio [WHR]), glucose tolerance (impaired glucose tolerance vs normal glucose tolerance), fasting insulin and compromised insulin secretion (as assessed by increment in insulin to the increment in glucose over the first 30 min of an oral glucose tolerance test (DI 30 /DG 30 )) to predict future NIDDM. In the 8-year follow-up of the San Antonio Heart Study, NIDDM developed in 11.7 % (107/914) of Mexican Americans and in 5.0 % (18/362) of nonHispanic whites (p < 0.001). Multivariate predictors of NIDDM by multiple logistic regression analysis included increased age, BMI, WHR, fasting insulin and impaired glucose tolerance and decreased insulin secretion. The strongest independent predictors of NIDDM were high fasting insulin and decreased insulin secretion. These risk factors predicted NIDDM equally well in high and low-risk populations. [Diabetologia (1997) 40: 62-66]

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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

Cited by 265 publications

References 0 publications

Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada

Characteristics and prevalence of the metabolic syndrome among three ethnic groups in Canada

Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes

Are risk factors for conversion to NIDDM similar in high and low risk populations?

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