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Black African men with early type 2 diabetes have similar muscle, liver and adipose tissue insulin sensitivity to White European men despite lower visceral fat

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Bello Oluwatoyosi, Cynthia Mohandas, Fariba Shojee-Moradie, Nicola Jackson, Olah Hakim, K. George M M Alberti, Janet L. Peacock, A. Margot Umpleby, Stephanie A. Amiel, Louise M. Goff

Original languageEnglish
Pages (from-to)835-844
Number of pages10
JournalDiabetologia
Volume62
Early online date6 Feb 2019
DOIs
Publication statusPublished - May 2019

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Abstract

Aims/hypothesis: Type 2 diabetes is more prevalent in Black African than White European populations although, paradoxically, they present with lower visceral fat, which has a known association with insulin resistance. Insulin resistance occurs at a tissue specific level however no study has simultaneously compared whole body, skeletal muscle, hepatic and adipose tissue insulin sensitivity between Black and White men. We hypothesised greater hepatic and adipose tissue insulin sensitivity in Black African (BAM) compared to White European men (WEM) with early type 2 diabetes, due to reduced visceral fat. Methods: Eighteen BAM and 15 WEM with type 2 diabetes, matched for BMI and age, underwent a 2 stage hyperinsulinaemic-euglycaemic clamp with glucose and glycerol stable isotope tracers to assess tissue specific insulin sensitivity and a magnetic resonance imaging scan to assess body composition. Results: We found no ethnic differences in whole body, skeletal muscle, hepatic or adipose tissue insulin sensitivity between BAM and WEM. This finding occurred in the presence of lower visceral fat in BAM (3.72 vs 5.68 kg [mean difference -1.96, 95% confidence interval -3.30, 0.62]; p= 0.01). There was an association between skeletal muscle and adipose tissue insulin sensitivity in WEM that was not present in BAM (r=0.78, p<0.01 vs r=0.25 p=0.37). Conclusions/interpretation: Our data suggest that in type 2 diabetes there are no ethnic differences in whole body, skeletal muscle, hepatic and adipose tissue insulin sensitivity between Black and White men despite differences in visceral adipose tissue, and that impaired lipolysis may not be contributing to skeletal muscle insulin resistance in men of Black African ethnicity.

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