Nonesterified Fatty Acids as Mediators of Glucose Intolerance in Indian Asian Populations
- Jeetesh V. Patel, PHD12,
- Avni Vyas, MPHIL1,
- Dorairaj Prabhakaran, MD3,
- Deepak Bhatnagar, PHD4,
- Paul N. Durrington, FMED SCI1,
- Adrien Heald, DPHIL5,
- Elizabeth A. Hughes, MBCHB2,
- Michael I. Mackness, PHD1,
- K. Srinath Reddy, MD3 and
- J. Kennedy Cruickshank, MD1
- 1Clinical Epidemiology & Cardiovascular Medicine Group, University Department of Medicine, University of Manchester, Manchester, U.K.
- 2Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, U.K.
- 3Department of Cardiology, All India Institute of Medical Sciences, Delhi, India
- 4Department of Clinical Biochemistry, Royal Oldham Hospital, Oldham, U.K.
- 5Department of Endocrine Sciences, Hope Hospital, Salford, U.K.
- Address correspondence and reprint requests to Dr. J.K. Cruickshank, University Dept. of Medicine, Manchester Royal Infirmary, Manchester M13 9WL, U.K. E-mail: clinep{at}man.ac.uk
In India, diabetes is endemic, linked to urbanization (1), and its dispersed migrant populations show a particular vulnerability (2,3). For example, in Britain, diabetes is more frequent among Indian migrants than in the general population (4,5), but reported rates appear to equal those in India (6), although diverse dietary and cultural habits across India are also likely to have an impact (7). Rates of glucose intolerance seem to be similar between particular Indian communities living in East Africa, and British population studies provide increasing support for a causal role of nonesterified fatty acids (NEFAs) in the etiology of type 2 diabetes (8,9). Here, using a standardized comparison of culturally specific Gujarati communities between India and Britain, we hypothesized that factors associated with disordered NEFA suppression following glucose challenge would confer greater glucose intolerance in these populations.
RESEARCH DESIGN AND METHODS
We compared a Gujarati community who had migrated to Sandwell (West Midlands, Britain) from rural villages around Navsari (Gujarat) with age-, sex-, and caste-matched contemporaries still living in those villages in India (as described elsewhere [10]). Randomly sampled participants from electoral rolls were invited to clinic sessions (beginning 8:30–10:00 a.m.). Participants without known diabetes had glucose tolerance testing (GTT) using …
