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Can body fat distribution, adiponectin levels and inflammation explain differences in insulin resistance between ethnic Chinese, Malays and Asian Indians?

International Journal of Obesity volume 36, pages 1086–1093 (2012)Cite this article

Subjects

Abstract

Objective:

Diabetes in Asia constitutes approximately half of the global burden. Although insulin resistance and incidence of type 2 diabetes differ substantially between ethnic groups within Asia, the reasons for these differences are poorly understood. We evaluated to what extent body fatness, adiponectin levels and inflammation mediate the relationship between ethnicity and insulin resistance in an Asian setting.

Design:

Cross-sectional population-based study.

Subjects:

In total, 4136 adult Chinese, Malays and Asian Indians residing in Singapore.

Measurements:

Insulin resistance was assessed using homeostasis model assessment (HOMA-IR) and systemic inflammation by C-reactive protein (CRP). Data were analyzed using path analysis.

Results:

HOMA-IR was highest in Asian Indians, intermediate in Malays and lowest in Chinese (P<0.001). The difference in HOMA-IR between Malays and Chinese disappeared after adjusting for body mass index (BMI). For the comparison of Asian Indians with Chinese, the association between ethnicity and HOMA-IR was mediated by BMI (men: 32.9%; women: 48.5%), BMI-adjusted waist circumference (men: 6.1%; women: 3.5%), and CRP (men: 5.1%; women: 5.6%), and unidentified factors (men: 47.2%; women: 26.5%). Part of the mediating effects of body fatness was indirect through effects of body fatness on CRP and adiponectin concentrations.

Conclusion:

Mediators of ethnic differences in insulin resistance differed markedly depending on the ethnic groups compared. General adiposity explained the difference in insulin resistance between Chinese and Malays, whereas abdominal fat distribution, inflammation and unexplained factors contributed to excess insulin resistance in Asian Indians as compared with Chinese and Malays. These findings suggest that interventions targeting excess weight gain can reduce ethnic disparities in insulin resistance among Asian Indians, Chinese and Malays.

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Acknowledgements

This study was supported by the Biomedical Research Council (Grant number 03/1/27/18/216) and the National Medical Research Council (Grant numbers 0838/2004 and NMRC/CSI/0002/2005).

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Authors and Affiliations

  1. Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    H Gao, A Salim, J Lee, E S Tai & R M van Dam

  2. NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore

    H Gao

  3. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    E S Tai & R M van Dam

  4. Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore

    E S Tai

  5. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    R M van Dam

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Correspondence to R M van Dam.

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Competing interests

In the past 2 years, Dr E Shyong Tai has been involved in advisory boards for Bristol Myers Squibb (Singapore) Pte Ltd, Astra Zeneca (Singapore) Pte Ltd. and Novo Nordisk Pharma (Singapore) Pte Ltd. He has also received honoraria as a speaker for Merck Sharp and Dohme (IA) Corp., Unilever and Abbot Laboratories. The remaining authors declare no conflict of interest.

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Gao, H., Salim, A., Lee, J. et al. Can body fat distribution, adiponectin levels and inflammation explain differences in insulin resistance between ethnic Chinese, Malays and Asian Indians?. Int J Obes 36, 1086–1093 (2012). https://doi.org/10.1038/ijo.2011.185

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  • DOI: https://doi.org/10.1038/ijo.2011.185

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