Adipose tissue distribution in relation to insulin sensitivity and inflammation in Pakistani and Norwegian subjects with type 2 diabetes

Abstract

Immigrants from South Asia to Western countries have a high prevalence of type 2 diabetes mellitus (T2DM) associated with obesity. We investigated the relationship between diabetes and adipose tissue distribution in a group of younger T2DM subjects from Norway and Pakistan. Eighteen immigrant Pakistani and 21 Norwegian T2DM subjects (age 29–45, 49% men) were included. They underwent anthropometrical measurements including bioelectrical impedance analysis, CT scans measuring fatty infiltration in liver and adipose and muscle tissue compartments in mid-abdomen and thigh, a euglycemic clamp, and blood samples for serum insulin and plasma glucose, adipokines and inflammation markers. Adipose tissue distribution was similar in Norwegians and Pakistanis. Pakistanis, but not Norwegians, showed a negative correlation between insulin sensitivity and visceral adipose tissue (VAT, r_s = − 0.704, p = 0.003). Subcutaneous adipose tissue (SAT) correlated to leptin in both Pakistanis and Norwegians (r_s = 0.88, p < 0.001 and 0.67, p = 0.001). SAT also correlated to C-reactive protein (CRP) in the Pakistanis only (r_s = 0.55, p = 0.03), and superficial SAT to Interleukin-1 receptor antagonist (IL-1RA) in Norwegians only (r_s = 0.47, p = 0.04). In conclusion, despite similar adipose tissue distribution in the two groups Pakistanis were more insulin resistant, with a negative correlation of VAT to insulin sensitivity, not present in Norwegians. The correlation of adipose tissue to Leptin, CRP and IL-1RA showed ethnic differences.

Key Words::

• Anthropometry
• C-reactive protein
• tomography
• X-ray computed
• immigrants
• insulin resistance
• Interleukin 1 receptor antagonist
• human
• Leptin
• Southern Asia
• subcutaneous adipose tissue
• visceral adipose tissue

Acknowledgements

The University of Oslo and the Eastern Norway Regional Health Authority funded this work. We greatly thank the study nurses Åse Halsne and Gøril Vinje at the Diabetes Research Laboratory of the Hormone Laboratory, Oslo University Hospital, for their skilled work in performing the study procedures, and BLS Lise-Marit Amlie at the Hormone Laboratory for invaluable help during planning and running of the study. Finally, we acknowledge LifeScan Inc. for supplying us with test-strips for the OneTouch Ultra glucose-monitoring device.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.