ETHNIC-DIFFERENCES IN SECRETION, SENSITIVITY, AND HEPATIC EXTRACTION OF INSULIN IN BLACK-AND-WHITE AMERICANS

被引:151
作者
OSEI, K [1 ]
SCHUSTER, DP [1 ]
机构
[1] OHIO STATE UNIV HOSP,DEPT INTERNAL MED,DIV ENDOCRINOL & METAB,COLUMBUS,OH 43210
关键词
BLACK AMERICANS; WHITE AMERICANS; INSULIN SENSITIVITY INDEX; HEPATIC INSULIN EXTRACTION;
D O I
10.1111/j.1464-5491.1994.tb00349.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Hyperinsulinaemia and abnormalities in hepatic insulin extraction commonly coexist in ethnic groups with severe insulin resistance. Therefore, we compared the effects of ethnicity on glucose/insulin/C-peptide dynamics, hepatic insulin extraction, and insulin sensitivity in healthy black (n = 32) and white (n = 30) Americans. Standard oral glucose tolerance test (OGTT) and tolbutamide-modified, frequently sampled, intravenous glucose tolerance (FSIVGT) tests were performed in each subject. Insulin sensitivity index (S(l)) was calculated using the MINIMOD method described by Bergman et al. Basal and post-stimulation hepatic insulin extraction were calculated by the molar ratios of C-peptide and insulin concentrations during the basal steady state and areas under the post-stimulation hormone curves, respectively. Apart from a slightly greater mean serum glucose peak response after oral glucose in the whites, mean glucose levels were identical in the blacks and whites during both stimulations. In contrast, serum insulin levels at basal and during both stimulations were significantly greater (2-3 fold) in the blacks than whites. However, the corresponding C-peptide responses were identical in both groups. The basal and postprandial hepatic insulin extraction were 33% and 45% lower in the blacks when compared to whites, respectively. The mean S1 was significantly (p < 0.02) lower in the blacks (4.93 +/- 0.46) than the whites (7.17 +/- 0.88 x 10(-4).min-1 (mU l-1)-1). We conclude that ethnicity may be a major determinant of the mechanism of peripheral hyperinsulinaemia and insulin insensitivity in black and white Americans.
引用
收藏
页码:755 / 762
页数:8
相关论文
共 32 条
[1]  
Bennett PH, Burch TA, Miller M., The High Prevalence of Diabetes in the Pima Indians of Arizona (USA), 221, pp. 33-39, (1970)
[2]  
Harris MI, Hadden WC, Knowler WC, Bennett PH, Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in US population aged 20–74, Diabetes, 36, pp. 523-524, (1987)
[3]  
Haffner SM, Stern MP, Mitchel B., Hazuda HP, Patterson JK, Incidence of type II diabetes in Mexican Americans predicted by fasting insulin and glucose levels, obesity and body fat distribution, Diabetes, 39, pp. 283-288, (1991)
[4]  
Zimmet P., Whitehouse S., Kiss J., Ethnic variability in the plasma insulin response to oral glucose in Polynesian and Micronesian subjects, Diabetes, 28, pp. 624-628, (1979)
[5]  
Cruickshank JK, Cooper J., Burnett M., MacDuff J., Drubra U., Ethnic differences in fasting plasma c‐peptide and insulin in relation to glucose tolerance and blood pressure, Lancet II, 338, pp. 824-827, (1991)
[6]  
Zimmet P., Type 2 (non‐insulin‐dependent) diabetes, an epidemiological overview, Diabetologia, 22, pp. 399-411, (1982)
[7]  
Freedman DS, Srinivasan SS, Burke GL, Shear CL, Smoak CG, Harsha DW, Et al., Relation of body fat distribution to hyperinsulinemia in children and adolescents. The Bogalusa Heart Study, Am J Clin Nutr, 46, pp. 403-410, (1987)
[8]  
Newman WP, Freedman DS, Voors AW, Gard PD, Srinivasan SR, Cresanta JL, Et al., Relations of serum lipoprotein levels and systolic blood pressure to early atherosclerosis: The Bogalusa Heart Study, N Engl J Med, 314, pp. 138-144, (1986)
[9]  
Svec F., Nastasi K., Hilton C., Bao W., Srinivasan SR, Berenson GS, Black‐white contrasts in insulin levels during pubertal developments: The Bogalusa Heart Study, Diabetes, 41, pp. 314-317, (1992)
[10]  
Osei K., Cottrell DA, Harris B., Differences in basal and post‐stimulation glucose homeostasis in nondiabetic first‐degree relatives of black and white patients with type 2 diabetes mellitus, J Clin Endocrinol Metab, 75, pp. 82-86, (1992)