Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study
Introduction Uncertainties exist on whether the main determinant of abnormal glucose tolerance (Abnl-GT) in Africans is β-cell failure or insulin resistance (IR). Therefore, we determined the prevalence, phenotype and characteristics of Abnl-GT due to β-cell failure versus IR in 486 African-born bla...
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BMJ Publishing Group
2021-03-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/9/1/e002447.full |
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| author | Thomas Hormenu Christopher W DuBose Lilian S Mabundo Joon Ha Arthur Sherman Anne E Sumner M C Sage Ishimwe Annemarie Wentzel Elyssa M Shoup Nana H Osei-Tutu Arielle C Patterson Hadi Bagheri |
| author_facet | Thomas Hormenu Christopher W DuBose Lilian S Mabundo Joon Ha Arthur Sherman Anne E Sumner M C Sage Ishimwe Annemarie Wentzel Elyssa M Shoup Nana H Osei-Tutu Arielle C Patterson Hadi Bagheri |
| author_sort | Thomas Hormenu |
| collection | DOAJ |
| description | Introduction Uncertainties exist on whether the main determinant of abnormal glucose tolerance (Abnl-GT) in Africans is β-cell failure or insulin resistance (IR). Therefore, we determined the prevalence, phenotype and characteristics of Abnl-GT due to β-cell failure versus IR in 486 African-born blacks (male: 64%, age: 38±10 years (mean±SD)) living in America.Research design and methods Oral glucose tolerance test were performed. Abnl-GT is a term which includes both diabetes and prediabetes and was defined as fasting plasma glucose (FPG) ≥5.6 mmol/L and/or 2-hour glucose ≥7.8 mmol/L. IR was defined by the lowest quartile of the Matsuda Index (≤2.98) and retested using the upper quartile of homeostatic model assessment of insulin resistance (HOMA-IR) (≥2.07). Abnl-GT-IR required both Abnl-GT and IR. Abnl-GT-β-cell failure was defined as Abnl-GT without IR. Beta-cell compensation was assessed by the Disposition Index (DI). Fasting lipids were measured. Visceral adipose tissue (VAT) volume was obtained with abdominal CT scan.Results The prevalence of Abnl-GT was 37% (182/486). For participants with Abnl-GT, IR occurred in 38% (69/182) and β-cell failure in 62% (113/182). Compared with Africans with Abnl-GT-IR, Africans with Abnl-GT-β-cell failure had lower body mass index (BMI) (30.8±4.3 vs 27.4±4.0 kg/m2), a lower prevalence of obesity (52% vs 19%), less VAT (163±72 vs 107±63 cm2), lower triglyceride (1.21±0.60 vs 0.85±0.42 mmol/L) and lower FPG (5.9±1.4 vs 5.3±0.6 mmol/L) and 2-hour glucose concentrations (10.0±3.1 vs 9.0±1.9 mmol/L) (all p<0.001) and higher DI, high-density lipoprotein (HDL), low-density lipoprotein particle size and HDL particle size (all p<0.01). Analyses with Matsuda Index and HOMA-IR yielded similar results. Potential confounders such as income, education, alcohol and fiber intake did not differ by group.Conclusions Beta-cell failure occurred in two-thirds of participants with Abnl-GT and may be a more frequent determinant of Abnl-GT in Africans than IR. As BMI category, degree of glycemia and lipid profile appeared more favorable when Abnl-GT was due to β-cell failure rather than IR, the clinical course and optimal interventions may differ.Trial registration number NCT00001853. |
| format | Article |
| id | doaj-art-1c09611b1e35458d8c7f65316ce80c41 |
| institution | Kabale University |
| issn | 2052-4897 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Diabetes Research & Care |
| spelling | doaj-art-1c09611b1e35458d8c7f65316ce80c412024-12-12T15:20:08ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2021-002447Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America studyThomas Hormenu0Christopher W DuBose1Lilian S Mabundo2Joon Ha3Arthur Sherman4Anne E Sumner5M C Sage Ishimwe6Annemarie Wentzel7Elyssa M Shoup8Nana H Osei-Tutu9Arielle C Patterson10Hadi Bagheri11NIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USANIDDK, National Institutes of Health, Bethesda, Maryland, USASchool of Global Public Health, Department of Social and Behavioral Sciences, ISEE Lab, New York University, New York, New York, USANIDDK, National Institutes of Health, Bethesda, Maryland, USAClinical Center, National Institutes of Health, Bethesda, Maryland, USAIntroduction Uncertainties exist on whether the main determinant of abnormal glucose tolerance (Abnl-GT) in Africans is β-cell failure or insulin resistance (IR). Therefore, we determined the prevalence, phenotype and characteristics of Abnl-GT due to β-cell failure versus IR in 486 African-born blacks (male: 64%, age: 38±10 years (mean±SD)) living in America.Research design and methods Oral glucose tolerance test were performed. Abnl-GT is a term which includes both diabetes and prediabetes and was defined as fasting plasma glucose (FPG) ≥5.6 mmol/L and/or 2-hour glucose ≥7.8 mmol/L. IR was defined by the lowest quartile of the Matsuda Index (≤2.98) and retested using the upper quartile of homeostatic model assessment of insulin resistance (HOMA-IR) (≥2.07). Abnl-GT-IR required both Abnl-GT and IR. Abnl-GT-β-cell failure was defined as Abnl-GT without IR. Beta-cell compensation was assessed by the Disposition Index (DI). Fasting lipids were measured. Visceral adipose tissue (VAT) volume was obtained with abdominal CT scan.Results The prevalence of Abnl-GT was 37% (182/486). For participants with Abnl-GT, IR occurred in 38% (69/182) and β-cell failure in 62% (113/182). Compared with Africans with Abnl-GT-IR, Africans with Abnl-GT-β-cell failure had lower body mass index (BMI) (30.8±4.3 vs 27.4±4.0 kg/m2), a lower prevalence of obesity (52% vs 19%), less VAT (163±72 vs 107±63 cm2), lower triglyceride (1.21±0.60 vs 0.85±0.42 mmol/L) and lower FPG (5.9±1.4 vs 5.3±0.6 mmol/L) and 2-hour glucose concentrations (10.0±3.1 vs 9.0±1.9 mmol/L) (all p<0.001) and higher DI, high-density lipoprotein (HDL), low-density lipoprotein particle size and HDL particle size (all p<0.01). Analyses with Matsuda Index and HOMA-IR yielded similar results. Potential confounders such as income, education, alcohol and fiber intake did not differ by group.Conclusions Beta-cell failure occurred in two-thirds of participants with Abnl-GT and may be a more frequent determinant of Abnl-GT in Africans than IR. As BMI category, degree of glycemia and lipid profile appeared more favorable when Abnl-GT was due to β-cell failure rather than IR, the clinical course and optimal interventions may differ.Trial registration number NCT00001853.https://drc.bmj.com/content/9/1/e002447.full |
| spellingShingle | Thomas Hormenu Christopher W DuBose Lilian S Mabundo Joon Ha Arthur Sherman Anne E Sumner M C Sage Ishimwe Annemarie Wentzel Elyssa M Shoup Nana H Osei-Tutu Arielle C Patterson Hadi Bagheri Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study BMJ Open Diabetes Research & Care |
| title | Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study |
| title_full | Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study |
| title_fullStr | Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study |
| title_full_unstemmed | Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study |
| title_short | Beta-cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in Africans: insight from the Africans in America study |
| title_sort | beta cell failure rather than insulin resistance is the major cause of abnormal glucose tolerance in africans insight from the africans in america study |
| url | https://drc.bmj.com/content/9/1/e002447.full |
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