Age trajectories of glycaemic traits in non-diabetic South Asian and white individuals: the Whitehall II cohort study

Satoyo Ikehara, A. Tabák, Tasnime N. Akbaraly, Adam Hulmán, Mika Kivimäki, Nita G. Forouhi, Hiroyasu Iso, Eric J. Brunner

Research output: Contribution to journalArticle

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Abstract

Aims/hypothesis: South Asian individuals have an increased prevalence of type 2 diabetes, but little is known about the development of glycaemic traits in this ethnic group. We compared age-related changes in glycaemic traits between non-diabetic South Asian and white participants.

Methods: In a prospective British occupational cohort with 5-yearly clinical examinations (n = 230/5,749 South Asian/white participants, age 39–79 years at baseline), age-related trajectories of fasting glucose (FG) and 2 h post-load glucose (PLG), log-transformed fasting insulin (FINS) and 2 h post-load insulin (PLINS), HOMA insulin sensitivity (HOMA2-%S) and HOMA insulin secretion (HOMA2-%B) were fitted for South Asian and white individuals who remained free of diabetes between 1991 and 2009.

Results: In sex-adjusted multilevel models, FG was stable in white participants but increased with age in South Asians (0.12 [SE = 0.04] mmol/l per decade). PLG, FINS and PLINS levels were lower among white participants (by 0.271 [SE = 0.092] mmol/l, 0.306 [SE = 0.046] log pmol/l, 0.707 [SE = 0.059] log pmol/l at age 50, respectively) compared with South Asians, although their age-related trajectories were parallel. HOMA2-%S was higher (0.226 [SE = 0.038] at age 50) and HOMA2-%B lower (by 0.189 [SE = 0.026] at age 50) among white than South Asian participants. The age-related decline in HOMA2-%S was similar in these groups, but the age-related increase in HOMA2-%B was greater in white participants (0.04 [SE = 0.02] per decade). This difference was explained by obesity, lifestyle and social status.

Conclusions/interpretation: Findings from a diabetes-free population suggest an inadequate pancreatic beta cell reserve in South Asians, as a significantly steeper age-related increase in FG was observed in this ethnic group compared with white individuals.

Original languageEnglish
Pages (from-to)534-542
Number of pages9
JournalDiabetologia
Volume58
Issue number3
DOIs
Publication statusPublished - 2014

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Fasting
Cohort Studies
Insulin
Glucose
Ethnic Groups
Insulin-Secreting Cells
Type 2 Diabetes Mellitus
Insulin Resistance
Life Style
Age Groups
Obesity
Population

Keywords

  • Cohort study
  • Ethnicity
  • Fasting glucose
  • Fasting insulin
  • Glycaemic trajectory
  • Insulin resistance
  • Insulin secretion
  • Insulin sensitivity
  • Post-load glucose
  • South Asian

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Age trajectories of glycaemic traits in non-diabetic South Asian and white individuals : the Whitehall II cohort study. / Ikehara, Satoyo; Tabák, A.; Akbaraly, Tasnime N.; Hulmán, Adam; Kivimäki, Mika; Forouhi, Nita G.; Iso, Hiroyasu; Brunner, Eric J.

In: Diabetologia, Vol. 58, No. 3, 2014, p. 534-542.

Research output: Contribution to journalArticle

Ikehara, S, Tabák, A, Akbaraly, TN, Hulmán, A, Kivimäki, M, Forouhi, NG, Iso, H & Brunner, EJ 2014, 'Age trajectories of glycaemic traits in non-diabetic South Asian and white individuals: the Whitehall II cohort study', Diabetologia, vol. 58, no. 3, pp. 534-542. https://doi.org/10.1007/s00125-014-3448-9
Ikehara, Satoyo ; Tabák, A. ; Akbaraly, Tasnime N. ; Hulmán, Adam ; Kivimäki, Mika ; Forouhi, Nita G. ; Iso, Hiroyasu ; Brunner, Eric J. / Age trajectories of glycaemic traits in non-diabetic South Asian and white individuals : the Whitehall II cohort study. In: Diabetologia. 2014 ; Vol. 58, No. 3. pp. 534-542.
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AU - Tabák, A.

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AU - Hulmán, Adam

AU - Kivimäki, Mika

AU - Forouhi, Nita G.

AU - Iso, Hiroyasu

AU - Brunner, Eric J.

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N2 - Aims/hypothesis: South Asian individuals have an increased prevalence of type 2 diabetes, but little is known about the development of glycaemic traits in this ethnic group. We compared age-related changes in glycaemic traits between non-diabetic South Asian and white participants.Methods: In a prospective British occupational cohort with 5-yearly clinical examinations (n = 230/5,749 South Asian/white participants, age 39–79 years at baseline), age-related trajectories of fasting glucose (FG) and 2 h post-load glucose (PLG), log-transformed fasting insulin (FINS) and 2 h post-load insulin (PLINS), HOMA insulin sensitivity (HOMA2-%S) and HOMA insulin secretion (HOMA2-%B) were fitted for South Asian and white individuals who remained free of diabetes between 1991 and 2009.Results: In sex-adjusted multilevel models, FG was stable in white participants but increased with age in South Asians (0.12 [SE = 0.04] mmol/l per decade). PLG, FINS and PLINS levels were lower among white participants (by 0.271 [SE = 0.092] mmol/l, 0.306 [SE = 0.046] log pmol/l, 0.707 [SE = 0.059] log pmol/l at age 50, respectively) compared with South Asians, although their age-related trajectories were parallel. HOMA2-%S was higher (0.226 [SE = 0.038] at age 50) and HOMA2-%B lower (by 0.189 [SE = 0.026] at age 50) among white than South Asian participants. The age-related decline in HOMA2-%S was similar in these groups, but the age-related increase in HOMA2-%B was greater in white participants (0.04 [SE = 0.02] per decade). This difference was explained by obesity, lifestyle and social status.Conclusions/interpretation: Findings from a diabetes-free population suggest an inadequate pancreatic beta cell reserve in South Asians, as a significantly steeper age-related increase in FG was observed in this ethnic group compared with white individuals.

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KW - Fasting glucose

KW - Fasting insulin

KW - Glycaemic trajectory

KW - Insulin resistance

KW - Insulin secretion

KW - Insulin sensitivity

KW - Post-load glucose

KW - South Asian

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