期刊
EUROPEAN JOURNAL OF ENDOCRINOLOGY
卷 186, 期 5, 页码 523-533出版社
BIOSCIENTIFICA LTD
DOI: 10.1530/EJE-21-0527
关键词
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资金
- South African Medical Research Council (MRC) from South African National Department of Health
- MRC UK
- GSK Africa Non-Communicable Disease Open Lab [ES/N013891/1]
- South African National Research Foundation [UID:98561]
- Wellcome Trust [214205/Z/18/Z]
- Wellcome Trust [214205/Z/18/Z] Funding Source: Wellcome Trust
Despite higher rates of overweight/obesity in Black South African women, the prevalence of type 2 diabetes does not differ between genders. This study found that men had lower insulin sensitivity and beta-cell function compared to women, and the association between adiposity and diabetes risk was stronger in men. These findings suggest that Black African men are at greater risk for type 2 diabetes with increasing adiposity.
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.
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