Download PDF
Horm Metab Res 2007; 39(12): 853-857
DOI: 10.1055/s-2007-993152
Mini Review

© Georg Thieme Verlag KG Stuttgart · New York

Insulin Resistance - The Role of Ethnicity: Evidence from Caucasian and African Cohorts

M. Reimann 1 , A. E. Schutte 2 , P. E. H. Schwarz 1
  • 1Department of Internal Medicine III, Clinic for Endocrinology, Diabetes and Metabolism, Technical University Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
  • 2School for Physiology, Nutrition and Consumer Sciences, North-West University (Potchefstroom campus), Potchefstroom, South Africa
Further Information

Publication History

received 20.08.2007

accepted 05.09.2007

Publication Date:
13 December 2007 (online)

Also available at
    Permissions and Reprints

Abstract

The risk for insulin resistance and subsequent type 2 diabetes varies between different ethnic populations due to differences in the genetic and environmental background. However, obesity and unhealthy lifestyle, crucial determinants of insulin resistance, are on the rise throughout all population groups though the susceptibility towards those factors may differ. Up to the present day it is not clear whether insulin resistance is based on metabolic changes due to lifestyle modifications or rather an ethnic and thus genetic grounded phenomenon. Genetic variations in secretion products of the active fat tissue (adipokines), a different pathophysiology of changes in glucose metabolism and the deep impact of urbanization (environmental factors) are discussed as primary determinants for differences in manifestation of insulin resistance between Caucasian and African populations. These factors may be influenced or modified by a central theme: visceral obesity. This mini review will elaborate on these issues illustrated by observations from Caucasian and African cohorts.

Key words

insulin resistance - ethnicity - African population - obesity - urbanization

References

  • 1 Schwarz PE, Schwarz J, Bornstein SR, Schulze J. Diabetes prevention-from physiology to implementation.  Horm Metab Res. 2006;  38 460-464
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Hanefeld M, Ceriello A, Schwarz PEH, Bornstein SR. The challenge of the metabolic syndrome.  Horm Metab Res. 2007;  39 625-626
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Schwarz PE, Bornstein SR. Pre-diabetes and metabolic syndrome in Germans.  Horm Metab Res. 2006;  38 359
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Hanefeld M, Ceriello A, Schwarz PE, Bornstein SR. The metabolic syndrome-a postprandial disease?.  Horm Metab Res. 2006;  38 435-436
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Bornstein SR, Wong ML, Licinio J. 150 years of Sigmund Freud: What would Freud have said about the obesity epidemic?.  Mol Psychiatry. 2006;  11 1070-1072
    CrossrefPubMedGoogle Scholar
  • 6 Cossrow N, Falkner B. Race/ethnic issues in obesity and obesity-related comorbidities.  J Clin Endocrinol Metab. 2004;  89 2590-2594
    CrossrefPubMedGoogle Scholar
  • 7 Schwarz PE. Report from the Congress of the American Diabetes Association (ADA): Orlando 2005-65th Annual Scientific Sessions in San Diego, CA, USA, June 10-14, 2005.  Exp Clin Endocrinol Diabetes. 2005;  113 475-479
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Schwarz PE. Congress report from the American Diabetes Association 66th Annual Scientific Sessions in Washington, USA.  Exp Clin Endocrinol Diabetes. 2006;  114 605-610
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Glasgow RE, Hiss RG, Anderson RM, Friedman NM, Hayward RA, Marrero DG, Taylor CB, Vinicor F. Report of the health care delivery work group: behavioral research related to the establishment of a chronic disease model for diabetes care.  Diabetes Care. 2001;  24 124-130
    CrossrefPubMedGoogle Scholar
  • 10 Triggs-Raine BL, Kirkpatrick RD, Kelly SL, Norquay LD, Cattini PA, Yamagata K, Hanley AJ, Zinman B, Harris SB, Barrett PH, Hegele RA. HNF-1alpha G319S, a transactivation-deficient mutant, is associated with altered dynamics of diabetes onset in an Oji-Cree community.  Proc Natl Acad Sci USA. 2002;  99 4614-4619
    CrossrefPubMedGoogle Scholar
  • 11 Maison P, Byrne CD, Hales CN, Day NE, Wareham NJ. Do different dimensions of the metabolic syndrome change together over time? Evidence supporting obesity as the central feature.  Diabetes Care. 2001;  24 1758-1763
    CrossrefPubMedGoogle Scholar
  • 12 Reaven GM. The insulin resistance syndrome: definition and dietary approaches to treatment.  Annu Rev Nutr. 2005;  25 391-406
    CrossrefPubMedGoogle Scholar
  • 13 Schuppenies A, Schwarz P, Bornstein SR. Seasonal affective disorder and HPA axis disturbance.  Horm Metab Res. 2006;  38 434
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Muscelli E, Emdin M, Natali A, Pratali L, Camastra S, Gastaldelli A, Baldi S, Carpeggiani C, Ferrannini E. Autonomic and hemodynamic responses to insulin in lean and obese humans.  J Clin Endocrinol Metab. 1998;  83 2084-2090
    CrossrefPubMedGoogle Scholar
  • 15 Lamounier-Zepter V, Ehrhart-Bornstein M, Bornstein SR. Metabolic syndrome and the endocrine stress system.  Horm Metab Res. 2006;  38 437-441
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Salehi M, Ferenczi A, Zumoff B. Obesity and cortisol status.  Horm Metab Res. 2005;  37 193-197
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Reichel A, Schwarz J, Schulze J, Licinio J, Wong ML, Bornstein SR. Depression and anxiety symptoms in diabetic patients on continuous subcutaneous insulin infusion (CSII).  Mol Psychiatry. 2005;  10 975-976
    CrossrefPubMedGoogle Scholar
  • 18 Korenblum W, Barthel A, Licinio J, Wong ML, Wolf OT, Kirschbaum C, Bornstein SR. Elevated cortisol levels and increased rates of diabetes and mood symptoms in Soviet Union-born Jewish immigrants to Germany.  Mol Psychiatry. 2005;  10 974-975
    CrossrefPubMedGoogle Scholar
  • 19 Bornstein SR, Schuppenies A, Wong ML, Licinio J. Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions.  Mol Psychiatry. 2006;  11 892-902
    CrossrefPubMedGoogle Scholar
  • 20 Schram MT, Stehouwer CD. Endothelial dysfunction, cellular adhesion molecules and the metabolic syndrome.  Horm Metab Res. 2005;  37 ((Suppl 1)) 49-55
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Greyling A, Pieters M, Hoekstra T, Oosthuizen W, Schutte AE. Differences in the association of PAI-1 activity with the metabolic syndrome between African and Caucasian women.  Nutr Metab Cardiovasc Dis. 2007;  17 499-507
    CrossrefPubMedGoogle Scholar
  • 22 Schmitz G, Langmann T. Metabolic learning in the intestine: adaptation to nutrition and luminal factors.  Horm Metab Res. 2006;  38 452-454
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Baricevic I, Jones DR, Nikolic JA, Nedic O. Gastrointestinal inflammation and the circulating IGF system in humans.  Horm Metab Res. 2006;  38 22-27
    PubMedGoogle Scholar
  • 24 Haffner SM. Insulin resistance, inflammation, and the prediabetic state.  Am J Cardiol. 2003;  92 18J-26J
    PubMedGoogle Scholar
  • 25 Joffe BI, Wing JR, Zouvanis M, Pieterse A, Seftel HC. NIDDM in African-Americans and black South Africans: many similarities but some important differences [letter].  Diabetes Care. 1996;  19 1451-1452
    PubMedGoogle Scholar
  • 26 Karim MA, Wang X, Hale TC, Elbein SC. Insulin Promoter Factor 1 variation is associated with type 2 diabetes in African Americans.  BMC Med Genet. 2005;  6 37
    CrossrefPubMedGoogle Scholar
  • 27 DECODA Study Group . Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts.  Diabetes Care. 2003;  26 61-69
    CrossrefPubMedGoogle Scholar
  • 28 Wilkinson A, Davidson J, Dotta F, Home PD, Keown P, Kiberd B, Jardine A, Levitt N, Marchetti P, Markell M, Naicker S, O'Connell P, Schnitzler M, Standl E, Torregosa JV, Uchida K, Valantine H, Villamil F, Vincenti F, Wissing M. Guidelines for the treatment and management of new-onset diabetes after transplantation.  Clin Transplant. 2005;  19 291-298
    CrossrefPubMedGoogle Scholar
  • 29 Vorster HH, Venter CS, Wissing MP, Margetts BM. The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.  Public Health Nutr. 2005;  8 480-490
    CrossrefPubMedGoogle Scholar
  • 30 Puoane T, Steyn K, Bradshaw D, Laubscher R, Fourie J, Lambert V, Mbananga N. Obesity in South Africa: the South African demographic and health survey.  Obes Res. 2002;  10 1038-1048
    CrossrefPubMedGoogle Scholar
  • 31 Schutte AE, Vuuren D van, Rooyen JM van, Huisman HW, Schutte R, Malan L, Malan NT. Inflammation, obesity and cardiovascular function in African and Caucasian women from South Africa: the POWIRS study.  J Hum Hypertens. 2006;  20 850-859
    CrossrefPubMedGoogle Scholar
  • 32 Lovejoy JC, Bretonne JA de la, Klemperer M, Tulley R. Abdominal fat distribution and metabolic risk factors: effects of race.  Metabolism. 1996;  45 1119-1124
    CrossrefPubMedGoogle Scholar
  • 33 Ntyintyane LM, Panz VR, Raal FJ, Gill GV. Metabolic syndrome, undiagnosed diabetes mellitus and insulin resistance are highly prevalent in urbanised South African blacks with coronary artery disease.  Cardiovasc J S Afr. 2006;  17 50-55
    PubMedGoogle Scholar
  • 34 Steyn K, Kazenellenbogen JM, Lombard CJ, Bourne LT. Urbanization and the risk for chronic diseases of lifestyle in the black population of the Cape Peninsula, South Africa.  J Cardiovasc Risk. 1997;  4 135-142
    CrossrefPubMedGoogle Scholar
  • 35 Oosthuizen W, Vorster HH, Kruger A, Venter CS, Kruger HS, Ridder JH de. Impact of urbanisation on serum lipid profiles - the THUSA survey.  S Afr Med J. 2002;  92 723-728
    PubMedGoogle Scholar
  • 36 Schwarz PE, Towers GW, Fischer S, Govindarajalu S, Schulze J, Bornstein SR, Hanefeld M, Vasseur F. Hypoadiponectinemia is associated with progression toward type 2 diabetes and genetic variation in the ADIPOQ gene promoter.  Diabetes Care. 2006;  29 1645-1650
    CrossrefPubMedGoogle Scholar
  • 37 Steppan CM, Bailey ST, Bhat S, Brown EJ, Banerjee RR, Wright CM, Patel HR, Ahima RS, Lazar MA. The hormone resistin links obesity to diabetes.  Nature. 2001;  409 307-312
    CrossrefPubMedGoogle Scholar
  • 38 Herman GA, Bergman A, Stevens C, Kotey P, Yi B, Zhao P, Dietrich B, Golor G, Schrodter A, Keymeulen B, Lasseter KC, Kipnes MS, Snyder K, Hilliard D, Tanen M, Cilissen C, Smet M De, Lepeleire I de, Dyck K Van, Wang AQ, Zeng W, Davies MJ, Tanaka W, Holst JJ, Deacon CF, Gottesdiener KM, Wagner JA. Effect of single oral doses of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on incretin and plasma glucose levels following an oral glucose tolerance test in patients with type 2 diabetes.  J Clin Endocrinol Metab. 2006;  91 4612-4619
    CrossrefPubMedGoogle Scholar
  • 39 Brown JS, Wing R, Barrett-Connor E, Nyberg LM, Kusek JW, Orchard TJ, Ma Y, Vittinghoff E, Kanaya AM. Lifestyle intervention is associated with lower prevalence of urinary incontinence: the Diabetes Prevention Program.  Diabetes Care. 2006;  29 385-390
    CrossrefPubMedGoogle Scholar
  • 40 Kamari Y, Grossman E, Oron-Herman M, Peleg E, Shabtay Z, Shamiss A, Sharabi Y. Metabolic stress with a high carbohydrate diet increases adiponectin levels.  Horm Metab Res. 2007;  39 384-388
    Article in Thieme ConnectPubMedGoogle Scholar
  • 41 Schutte AE, Huisman HW, Schutte R, Malan L, Rooyen JM van, Malan NT, Schwarz PE. Differences and similarities regarding adiponectin investigated in African and Caucasian women.  Eur J Endocrinol. 2007;  157 181-188
    CrossrefPubMedGoogle Scholar
  • 42 Thamer C, Haap M, Heller E, Joel L, Braun S, Tschritter O, Haring H, Fritsche A. Beta cell function, insulin resistance and plasma adiponectin concentrations are predictors for the change of postprandial glucose in non-diabetic subjects at risk for type 2 diabetes.  Horm Metab Res. 2006;  38 178-182
    Article in Thieme ConnectPubMedGoogle Scholar
  • 43 Ferris WF, Naran NH, Crowther NJ, Rheeder P, Merwe L van der, Chetty N. The relationship between insulin sensitivity and serum adiponectin levels in three population groups.  Horm Metab Res. 2005;  37 695-701
    Article in Thieme ConnectPubMedGoogle Scholar
  • 44 Olckers A, Towers GW, Merwe A van der, Schwarz PE, Rheeder P, Schutte AE. Protective effect against type 2 diabetes mellitus identified within the ACDC gene in a black South African diabetic cohort.  Metabolism. 2007;  56 587-592
    CrossrefPubMedGoogle Scholar
  • 45 Schwarz PE, Govindarajalu S, Towers W, Schwanebeck U, Fischer S, Vasseur F, Bornstein SR, Schulze J. Haplotypes in the promoter region of the ADIPOQ gene are associated with increased diabetes risk in a German Caucasian population.  Horm Metab Res. 2006;  38 447-451
    Article in Thieme ConnectPubMedGoogle Scholar
  • 46 Pereira MA, Jacobs Jr DR, Horn L Van, Slattery ML, Kartashov AI, Ludwig DS. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study.  JAMA. 2002;  287 2081-2089
    CrossrefPubMedGoogle Scholar
  • 47 Reimann M, Schutte AE, Huisman HW, Schutte R, Rooyen JM van, Malan L, Malan NT, Schwarz PE. Ethnic differences in C-peptide secretion but not in non-esterified fatty acid metabolism in pre-menopausal women with and without abdominal obesity.  Diabetes Res Clin Pract. 2007;  77 62-69
    CrossrefPubMedGoogle Scholar
  • 48 Malan L, Schutte AE, Malan NT, Wissing MP, Vorster HH, Steyn HS, Rooyen JM van, Huisman HW. Coping mechanisms, perception of health and cardiovascular dysfunction in Africans.  Int J Psychophysiol. 2006;  61 158-166
    CrossrefPubMedGoogle Scholar
  • 49 Vorster HH. The emergence of cardiovascular disease during urbanisation of Africans.  Public Health Nutr. 2002;  5 239-243
    PubMedGoogle Scholar
  • 50 MacIntyre UE, Kruger HS, Venter CS, Vorster HH. Dietary intakes of an African population in different stages of transition in the North West Province, South Africa, the THUSA study.  Nutr Res. 2002;  23-256
    PubMedGoogle Scholar
  • 51 Stephens C. Urbanisation: the implications for health.  Afr Health. 1996;  18 14-15
    PubMedGoogle Scholar
  • 52 Walker AR, Adam F, Walker BF. World pandemic of obesity: the situation in Southern African populations.  Public Health. 2001;  115 368-372
    PubMedGoogle Scholar
  • 53 Opie LH, Seedat YK. Hypertension in sub-Saharan African populations.  Circulation. 2005;  112 3562-3568
    CrossrefPubMedGoogle Scholar
  • 54 Akinboboye O, Idris O, Akinboboye O, Akinkugbe O. Trends in coronary artery disease and associated risk factors in sub-Saharan Africans.  J Hum Hypertens. 2003;  17 381-387
    CrossrefPubMedGoogle Scholar
  • 55 Muna WF. Cardiovascular disorders in Africa.  World Health Stat Q. 1993;  46 125-133
    PubMedGoogle Scholar
  • 56 Schutte AE, Kruger HS, Wissing MP, Underhay C, Vorster HH. The emergence of the metabolic syndrome in urban obese African women: The POWIRS-study.  S Afr J Sci. 2005;  101 61-67
    PubMedGoogle Scholar
  • 57 Schwarz PEH, Peltonen M. Prevention of type 2 diabetes - lessons we have learned for implementation.  Horm Metab Res. 2007;  39 636-641
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Lindstrom J, Tuomilehto J. The Diabetes Risk Score: A practical tool to predict type 2 diabetes risk.  Diabetes Care. 2003;  26 725-731
    CrossrefPubMedGoogle Scholar
  • 59 Schlesinger JB, Harmelen V van, Alberti-Huber CE, Hauner H. Albumin inhibits adipogenesis and stimulates cytokine release from human adipocytes.  Am J Physiol Cell Physiol. 2006;  291 C27-C33
    CrossrefPubMedGoogle Scholar
  • 60 Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention.  Diabet Med. 2007;  24 451-463
    CrossrefPubMedGoogle Scholar
  • 61 Schutte AE. Metabolic syndrome risk in black South African women compared to Caucasian women.  Horm Metab Res. 2007;  39 651-657
    Article in Thieme ConnectPubMedGoogle Scholar
  • 62 Schwarz PE, Schwarz J, Schuppenies A, Bornstein SR, Schulze J. Development of a diabetes prevention management program for clinical practice.  Public Health Rep. 2007;  122 258-263
    CrossrefPubMedGoogle Scholar
  • 63 Tuomilehto J. Modeling of primary prevention of the development of type 2 diabetes.  Przegl Lek. 2006;  63 ((Suppl 4)) 3-6
    PubMedGoogle Scholar
  • 64 Tuomilehto J. Counterpoint: Evidence-based prevention of type 2 diabetes: the power of lifestyle management.  Diabetes Care. 2007;  30 435-438
    CrossrefPubMedGoogle Scholar

Correspondence

Dr. P. E. H. Schwarz

Division of Endocrinology

Department of Medicine III

Medical Faculty Carl-Gustav-Carus

Technical University Dresden

01307 Dresden

Germany

Phone: +49/351/458 27 15

Fax: +49/351/458 73 19

Email: peter.schwarz@uniklinikum-dresden.de

      >