Table 3.
Features of glucose metabolism in minority populations relative to NHWs
| First author, year (Ref.) | Population | Method of assessing glucose metabolism | Findings relative to NHWs |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fasting glucose | 2-h post-load glucose | Fasting insulin | 2-h post-load insulin | Insulin-mediated glucose disposal or other measures of insulin sensitivity | AIR or other measure of β-cell function | Other | ||||||
| NHBs | ||||||||||||
| Haffner, 1996 (23) | IRAS; n = 288 NHBs, 435 NHWs nondiabetic | 2-h OGTT; insulin-modified frequently sampled iv glucose tolerance test | ↑ | ↑ | ↓ | ↑ | Differences persisted after adjustment for obesity, body fat distribution, and behavioral factors | |||||
| Donahue, 1997 (24) | Miami Community Health Study; n = 159 NHBs, 207 NHWs | 75-g OGTT (insulin area under the curve) | ↑ | Persisted after adjustment for percentage body fat | ||||||||
| Chiu, 2001 (29) | n = 28 NHBs, 45 NHWs | Hyperglycemic clamp | ↓ | ↑ | Persisted after adjustment for age, sex, BMI, WHR, and blood pressure | |||||||
| Carnethon, 2002 (25) | ARIC Study; n = 13,416 NHB and NHW nondiabetic men and women | Fasting insulin | ↑ | Fasting insulin was significantly higher among nonobese NHB compared to NHW women, but there was no difference among men | ||||||||
| Jensen, 2002 (31) | First-degree relatives of individuals with type 2 diabetes; n = 55 NHBs, 217 NHWs | 2-h OGTT; HOMA-IR estimated insulin resistance; ratio of incremental insulin to glucose responses over first 30 min (ΔI30/ΔG30) | ↑ | Adjustment for HOMA-IR explained difference in AIR between Hispanics and NHWs | ||||||||
| Torrens, 2004 (30) | SWAN study; nondiabetic pre- and perimenopausal women; n = 746 NHBs, 1,359 NHWs | HOMA %S (insulin sensitivity), HOMA %β (β-cell function) | ↓ | ↑ | Difference in HOMA %S and HOMA %β persisted after adjustment for WC, presence of IFG, TG, and site | |||||||
| Albu, 2005 (26) | n = 32 NHB women, 28 NHW women | Intravenous glucose tolerance test | ↓ | ↑ | Difference in insulin sensitivity persisted after adjustment for weight, height, and MRI-assessed intramuscular adipose tissue, but was attenuated after adjustment for MRI-assessed skeletal muscle volume. Differences in AIR persisted after multivariable adjustment | |||||||
| Rasouli, 2007 (27) | n = 55 NHBs, 85 NHWs; healthy, obese nondiabetic individuals | Intravenous glucose tolerance test | ↓ | ↑ | NHBs also had higher disposition index but lower maximum disposition index than age-, sex-, and BMI-matched NHWs | |||||||
| Chow, 2011 (28) | n = 17 NHB women, 17 NHW women; healthy, obese | Insulin-modified frequently sampled iv glucose tolerance test | ↓ | ↑ | NHB women had higher free fatty acid clearance after adjusting for fat mass. Additional adjustment for AIR attenuated the association | |||||||
| Hispanic-Americans | ||||||||||||
| Boyko, 1991 (32) | n = 464 Hispanic-Americans, 676 NHWs; normal glucose tolerance | Fasting, 1-h and 2-h glucose insulin from OGTT | ↑ | ↑ | Differences in fasting, 1-h, and 2-h insulin persisted after adjustment for age, sex, BMI, WHR, family history of diabetes, and glucose. ↑ Fasting and 1-h and 2-h glucose-stimulated C-peptide and C-peptide:insulin molar ratio greater in Hispanics than NHWs | |||||||
| Haffner, 1996 (23) | IRAS; n = 363 Hispanic-Americans, 435 NHWs; nondiabetic | 2-h OGTT; insulin-modified frequently sampled iv glucose tolerance test | ↑ | ↑ | ↓ | ↑ | Differences in 2-h insulin and AIR persisted after adjustment for obesity, body fat distribution, and behavioral factors, but differences in insulin sensitivity index did not persist | |||||
| Donahue, 1997 (24) | Miami Community Health Study; n = 128 Cuban-Americans, 207 NHWs | 75-g OGTT (insulin area under the curve) | ↑ | Persisted after adjustment for percentage body fat | ||||||||
| Chiu, 2001 (29) | n = 20 Mexican-Americans, 45 NHWs | Hyperglycemic clamp | ↓ | ↑ | Persisted after adjustment for age, sex, BMI, WHR, and blood pressure | |||||||
| Jensen, 2002 (31) | First-degree relatives of individuals with type 2 diabetes; n = 193 Hispanic-American, 217 NHWs | 2-h OGTT, HOMA-IR estimated insulin resistance, ratio of incremental insulin to glucose responses over first 30 min (ΔI30/ΔG30) | ↓ | ↑ | Difference in insulin resistance persisted after adjustment for BMI. Adjustment for HOMA-IR explained difference in AIR between Hispanics and NHWs | |||||||
| Ferrannini, 2003 (33) | n = 172 Mexican-Americans, 60 NHWs; NGT or diabetes | Insulin sensitivity of glucose uptake by clamp technique; endogenous glucose production by 3-[3H] glucose infusion; insulin secretory response to oral glucose | ↓ | No difference | Persisted after adjustment for BMI, age, diabetes, and family history of diabetes | |||||||
| Torrens, 2004 (30) | SWAN study; nondiabetic pre- and perimenopausal women; n = 218 non-Mexican-American Latinos, 1,359 NHWs | HOMA %S (insulin sensitivity); HOMA %β (β-cell function) | No difference | No difference | Lack of difference in HOMA %S persisted after adjustment for WC, presence of IFG, TG, and site | |||||||
| Asian-Americans and Pacific Islanders | ||||||||||||
| Chiu, 2001 (29) | n = 28 Asian-Americans, 45 NHWs | Hyperglycemic clamp | ↓ | ↑ | Persisted after adjustment for age, sex, BMI, WHR, and blood pressure | |||||||
| Jensen, 2002 (31) | First-degree relatives of individuals with type 2 diabetes; n = 66 Asian-Americans, 217 NHWs | 2-h OGTT; HOMA-IR estimated insulin resistance; ratio of incremental insulin to glucose responses over first 30 min (ΔI30/ΔG30) | ↑ | ↓ | Less insulin resistance for Asian-Americans compared to NHWs and other ethnic groups (NHB, Hispanic-American); persisted after adjustment for BMI. AIR was lower in Asian-Americans compared to other ethnic groups but was attenuated after adjustment for HOMA-IR | |||||||
| Torrens, 2004 (30) | SWAN study; nondiabetic pre- and perimenopausal women; n = 210 Chinese-Americans, 255 Japanese-Americans, 1,359 NHWs | HOMA %S (insulin sensitivity), HOMA %β (β-cell function) | ↓ | ↓ | Difference in HOMA %S persisted after adjustment for WC, presence of IFG, and site, but was attenuated after adjustment for TG. Differences in HOMA %β persisted after multivariable adjustment | |||||||
| Native Americans | ||||||||||||
| Resnick, 2002 (34) | Strong Heart Study; n = 61 Native Americans (compared to NHWs in IRAS) | Frequently sampled iv glucose tolerance test | ↓ | Mean insulin sensitivity index of nondiabetic Native Americans was lower than that of nondiabetic counterparts in IRAS (with exception of some Hispanic-Americans). The insulin sensitivity index of diabetic Native Americans was lower than that of all diabetic IRAS participants | ||||||||
AIR, Acute insulin response; ARIC, Atherosclerosis Risk in Communities Study; HOMA-IR, homeostatic model assessment of insulin resistance; IFG, impaired fasting glucose; IRAS, Insulin Resistance Atherosclerosis Study; MRI, magnetic resonance imaging; NGT, normal glucose tolerance; OGTT, oral glucose tolerance test; SWAN, Study of Women Across the Nation; WHR, waist-hip ratio;
↑
, increased compared to NHWs;
↓
, decreased compared to NHWs.