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Ethnic Differences in Insulin Sensitivity and ß-Cell Function in Premenopausal or Early Perimenopausal Women Without Diabetes

The Study of Women’s Health Across the Nation (SWAN)

¹ Department of Obstetrics Gynecology and Women’s Health, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
² Department of Preventive Medicine, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
³ David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
⁴ Division of Reproductive Medicine, Albert Einstein School of Medicine, New York, New York
⁵ Hispanic Center of Excellence, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
⁶ Department of Medicine, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey

Address correspondence and reprint requests to Javier I. Torréns, MD, New Jersey Medical School, UMDNJ Department of Obstetrics, Gynecology and Women’s Health MSB-E-506, 185 South Orange Ave., Newark, NJ 07103. E-mail: torrenji{at}umdnj. edu

OBJECTIVE—To assess differences in insulin sensitivity and ß-cell function between nondiabetic premenopausal or early perimenopausal non-Hispanic white women and African American, Chinese American, Japanese American, and non–Mexican-American Latino women.

RESEARCH DESIGN AND METHODS—Homeostasis model assessments (HOMAs) of insulin sensitivity (HOMA%S) and ß-cell function (HOMA%ß) were used. Stepwise multivariable ethnic-specific ANCOVA models were used to compare HOMA%S and HOMA%ß between non-Hispanic whites and each of the four ethnic groups.

RESULTS—HOMA%S was lower in African Americans, Chinese Americans, and Japanese Americans when compared with non-Hispanic white women after correcting for waist circumference, presence of impaired fasting glucose, and site. Significant differences persisted only between African Americans and non-Hispanic whites after inclusion of triglycerides in the model. Triglycerides indirectly corrected for the differences in HOMA%S in the other two groups. There were no differences in HOMA%S between the non–Mexican-American Latinos and the non-Hispanic whites. Japanese Americans and Chinese Americans had lower HOMA%ß than non-Hispanic whites, whereas African Americans had higher HOMA%ß than non-Hispanic whites after correcting for confounders. HOMA%ß was similar between non–Mexican-American Latinos and non-Hispanic whites.

CONCLUSIONS—These data suggest that type 2 diabetes prevention strategies for African-American women should initially target decreased insulin sensitivity, whereas strategies for Japanese-American and Chinese-American women may initially need to target both decreased insulin sensitivity and ß-cell function. Previous studies of Mexican-American populations may not apply to non–Mexican-American Latino women.

Abbreviations: GENNID, Genetics of Non-Insulin Dependent Diabetes Mellitus • HOMA, homeostasis model assessment • HOMA%ß, HOMA of ß-cell function • HOMA%S, HOMA of insulin sensitivity • NCEP ATP III, National Cholesterol Education Program Adult Treatment Panel III • SWAN, Study of Women’s Health Across the Nation

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