Yale Bulletin and Calendar

December 15, 2006|Volume 35, Number 13|Four-Week Issue

Asian Indian men found to be
more susceptible to diabetes

Asian Indian men are at increased risk to develop type 2 diabetes mellitus because of chronic liver disease rather than obesity, School of Medicine researchers report in the Nov. 13 issue of the Proceedings of the National Academy of Sciences.

Diabetes mellitus is strongly associated with obesity in most, but not all, ethnic groups, and the study was intended to examine ethnic differences in disease susceptibility. The risk statement is based on the researchers' finding that insulin resistance associated with non-alcoholic fatty liver disease is three to four times more prevalent in healthy, lean Asian Indian men than in lean men of other ethnic groups.

"The worldwide prevalence of type 2 diabetes mellitus is expected to double within the next two decades with the greatest increase occurring in Asia and the Indian subcontinent, where it will affect 130 million individuals," says the principal investigator, Dr. Gerald Shulman, a Howard Hughes Medical Institute investigator and professor of internal medicine and cellular and molecular physiology. "This might explain why Asian Indians tend to develop type 2 diabetes mellitus without the same degree of obesity found in most other ethnic groups."

The insulin resistance was not found in Asian Indian women, which might indicate protective effects of estrogen on this process, the researchers note.

In the study, an oral glucose tolerance test to assess whole body insulin sensitivity and magnetic resonance imaging measured liver fat content of 482 young, lean, healthy, sedentary, non-smoking people of Eastern Asian, Asian Indian and African descent, as well as Caucasians and Hispanics. The prevalence of insulin resistance was about three- to four-fold higher in the Asian Indian men compared to other ethnic groups and was associated with an approximately two-fold increase in hepatic triglyceride content.

Shulman says that based on his previous studies it is likely that the increased liver fat content was playing an important role in causing the insulin resistance. He also notes that these data have potentially important implications for the prevention and treatment of type 2 diabetes in these individuals.

Co-authors include Kitt Falk Petersen, Jing Feng, Douglas Befroy and James Dziura of Yale; and Chiara Dalla Man and Claudio Cobelli of the University of Padova, Italy.

-- By Jacqueline Weaver

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