Increased risk for type 2 diabetes in relation to adiposity in middle-aged Black South African men compared to women. Issue 5 (23rd March 2022)

• Record Type: Journal Article
• Authors: Kufe, Clement N; Micklesfield, Lisa K; Masemola, Maphoko; Chikowore, Tinashe; Kengne, Andre P; Karpe, Fredrik; Norris, Shane A; Crowther, Nigel J; Olsson, Tommy; Goedecke, Julia H
• Is Part Of: European journal of endocrinology. Volume 186:Issue 5(2022)
• Page Start: 523
• Page End: 533
• Publication Date: 2022-03-23
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EJE-21-0527
• Languages: English
• ISSNs: 0804-4643

Abstract

Abstract: Aims: Despite a higher prevalence of overweight/obesity in Black South African women compared to men, the prevalence of type 2 diabetes (T2D) does not differ. We explored if this could be due to sex differences in insulin sensitivity, clearance and/or beta-cell function and also sex-specific associations with total and regional adiposity. Methods: This cross-sectional study included 804 Black South African men ( n = 388) and women ( n = 416). Dual-energy X-ray absorptiometry was used to measure total and regional adiposity. Insulin sensitivity (Matsuda index), secretion (C-peptide index) and clearance (C-peptide/insulin ratio) were estimated from an oral glucose tolerance test. Results: After adjusting for sex differences in the fat mass index, men were less insulin sensitive and had lower beta-cell function than women ( P < 0.001), with the strength of the associations with measures of total and central adiposity being greater in men than women ( P < 0.001 for interactions). Further, the association between total adiposity and T2D risk was also greater in men than women (relative risk ratio (95% CI): 2.05 (1.42–2.96), P < 0.001 vs 1.38 (1.03–1.85), P = 0.031). Conclusion: With increasing adiposity, particularly increased centralisation of body fat linked to decreased insulin sensitivity and beta-cell function, Black African men are at greater risk for T2D than their female counterparts.