Non-Traditional Risk Factors are Important Contributors to the Racial Disparity in Diabetes Risk: The Atherosclerosis Risk in Communities Study

Journal of General Internal Medicine: February 2014

BACKGROUND

Traditional risk factors, particularly obesity, do not completely explain the excess risk of diabetes among African Americans compared to whites.

OBJECTIVE

We sought to quantify the impact of recently identified, non-traditional risk factors on the racial disparity in diabetes risk.

DESIGN

Prospective cohort study.

PARTICIPANTS

We analyzed data from 2,322 African-American and 8,840 white participants without diabetes at baseline from the Atherosclerosis Risk in Communities (ARIC) Study. Read more

“Es como uno bomba de tiempo [It’s like a time bomb]”: A Qualitative Analysis of Perceptions of Diabetes Among First-Degree Relatives of Latino Patients With Diabetes

Diabetes Spectrum: February 2014

Background. The South Bronx, a largely Latino community, has become an epicenter of the diabetes epidemic in New York City. In this community, nondiabetic first-degree relatives of people with diabetes are prime targets for intervention. Therefore, the objective of this study was to explore the knowledge of diabetes and attitudes toward health behavior modification of Latino adults who are first-degree relatives of people with diabetes. Read more

A 5-Day High-Fat, High-Calorie Diet Impairs Insulin Sensitivity in Healthy, Young South Asian Men but Not in Caucasian Men

Diabetes: January 2014

South Asians (SAs) develop type 2 diabetes at a younger age and lower BMI compared with Caucasians (Cs). The underlying cause is still poorly understood but might result from an innate inability to adapt to the Westernized diet. This study aimed to compare the metabolic adaptation to a high-fat, high-calorie (HFHC) diet between both ethnicities. Twelve healthy, young lean male SAs and 12 matched Cs underwent a two-step hyperinsulinemic-euglycemic clamp with skeletal muscle biopsies and indirect calorimetry before and after a 5-day HFHC diet. Hepatic triglyceride content (HTG) and abdominal fat distribution were assessed using magnetic resonance imaging and spectroscopy. At baseline, SAs had higher insulin clamp levels than Cs, indicating reduced insulin clearance rate. Despite the higher insulin levels, endogenous glucose production was comparable between groups, suggesting lower hepatic insulin sensitivity in SAs. Read more

Sequence variants in SLC16A11 are a common risk factor for type 2 diabetes in Mexico

Nature: December 25, 2013

Performing genetic studies in multiple human populations can identify disease risk alleles that are common in one population but rare in others1, with the potential to illuminate pathophysiology, health disparities, and the population genetic origins of disease alleles. Here we analysed 9.2 million single nucleotide polymorphisms (SNPs) in each of 8,214 Mexicans and other Latin Americans: 3,848 with type 2 diabetes and 4,366 non-diabetic controls. In addition to replicating previous findings2, 3, 4, we identified a novel locus associated with type 2 diabetes at genome-wide significance spanning the solute carriers SLC16A11 and SLC16A13 (P = 3.9 × 10−13; odds ratio (OR) = 1.29). The association was stronger in younger, leaner people with type 2 diabetes, and replicated in independent samples (P = 1.1 × 10−4; OR = 1.20). The risk haplotype carries four amino acid substitutions, all in SLC16A11; it is present at ~50% frequency in Native American samples and ~10% in east Asian, but is rare in European and African samples. Read More

Independent roles of country of birth and socioeconomic status in the occurrence of type 2 diabetes

Biomedcentral: December 23, 2013

Background

There is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes. However, the independent roles of socioeconomic status, country of birth and lifestyle factors in the occurrence of type 2 diabetes have not been clearly identified. This study investigated the relationships between socioeconomic status, country of birth and type 2 diabetes in a large diverse sample of residents of New South Wales, Australia, and aged 45 years and over.

Methods

The analysis used self-reported baseline questionnaire data from 266,848 participants in the 45 and Up Study. Educational attainment, work status and income were used as indicators of socioeconomic status. Logistic regression models were built to investigate associations between socioeconomic status, country of birth and type 2 diabetes. Read More

Body fat partitioning does not explain the inter-ethnic variation in insulin sensitivity among Asian ethnicity: the Singapore Adults Metabolism Study (SAMS)

Diabetes December 18, 2013

We previously showed that ethnicity modifies the association between adiposity and insulin resistance. We sought to determine whether differential body fat partitioning or abnormalities in muscle insulin signaling associated with higher levels of adiposity might underlie this observation. We measured insulin sensitivity index (ISI), %body fat, visceral (VAT) and subcutaneous (SAT) adipose tissue, liver fat and intramyocellular lipids (IMCL) in 101 Chinese, 82 Malays and 81 South Asians as well as p-Akt levels in cultured myoblasts from Chinese and South Asians. Lean Chinese and Malays had higher ISI than South Asians. Although ISI was lower in all ethnic groups when %body fat was higher, this association was stronger in Chinese and Malays such that, in overweight individuals, no ethnic differences were observed. These ethnic differences were observed even when %body fat was replaced with fat in other depots. Myoblasts obtained from lean South Asians had lower p-Akt levels than those from lean Chinese. Read more

Diabetes identified as risk factor for liver cancer across ethnic groups

Medicalxpress: December 8, 2013

Diabetes was associated with an increased risk for developing a type of liver cancer called hepatocellular carcinoma, and this association was highest for Latinos, followed by Hawaiians, African-Americans, and Japanese-Americans, according to results presented here at the Sixth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held Dec. 6-9.

People with diabetes have a two- to threefold higher risk for hepatocellular carcinomacompared with those without diabetes,” said V. Wendy Setiawan, Ph.D., assistant professor in the Department of Preventive Medicine at Keck School of Medicine of the University of Southern California. “We also found that the interethnic differences in the prevalence of diabetes were consistent with the pattern of hepatocellular carcinoma incidence observed across ethnicities: Ethnic groups with a high prevalence of diabetes also have high hepatocellular carcinoma rates, and those with a lower prevalence of diabetes have lower hepatocellular carcinoma rates.” Read More