Differential Effects of Abdominal Adipose Tissue Distribution on Insulin Sensitivity in Black and White South African Women

Authors

  • Julia H. Goedecke,

    Corresponding author
    1. Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
    2. South African Medical Research Council, Cape Town, South Africa
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  • Naomi S. Levitt,

    1. Endocrine Unit, Department of Medicine, University of Cape Town, Cape Town, South Africa
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  • Estelle V. Lambert,

    1. Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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  • Kristina M. Utzschneider,

    1. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington, USA
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  • Mirjam V. Faulenbach,

    1. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington, USA
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  • Joel A. Dave,

    1. Endocrine Unit, Department of Medicine, University of Cape Town, Cape Town, South Africa
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  • Sacha West,

    1. Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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  • Hendriena Victor,

    1. Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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  • Juliet Evans,

    1. Department of Human Biology, UCT/MRC Research Unit for Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
    2. Department of Public Health and Clinical Medicine, Department of Medicine, Umeå University, Umeå, Sweden
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  • Tommy Olsson,

    1. Department of Public Health and Clinical Medicine, Department of Medicine, Umeå University, Umeå, Sweden
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  • Brian R. Walker,

    1. Endocrinology Unit, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland
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  • Jonathan R. Seckl,

    1. Endocrinology Unit, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland
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  • Steven E. Kahn

    1. Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington, USA
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(julia.goedecke@uct.ac.za)

Abstract

Black South African women are more insulin resistant than BMI-matched white women. The objective of the study was to characterize the determinants of insulin sensitivity in black and white South African women matched for BMI. A total of 57 normal-weight (BMI 18–25 kg/m2) and obese (BMI > 30 kg/m2) black and white premenopausal South African women underwent the following measurements: body composition (dual-energy X-ray absorptiometry), body fat distribution (computerized tomography (CT)), insulin sensitivity (SI, frequently sampled intravenous glucose tolerance test), dietary intake (food frequency questionnaire), physical activity (Global Physical Activity Questionnaire), and socioeconomic status (SES, demographic questionnaire). Black women were less insulin sensitive (4.4 ± 0.8 vs. 9.5 ± 0.8 and 3.0 ± 0.8 vs. 6.0 ± 0.8 × 10−5/min/(pmol/l), for normal-weight and obese women, respectively, P < 0.001), but had less visceral adipose tissue (VAT) (P = 0.051), more abdominal superficial subcutaneous adipose tissue (SAT) (P = 0.003), lower SES (P < 0.001), and higher dietary fat intake (P = 0.001) than white women matched for BMI. SI correlated with deep and superficial SAT in both black (R = −0.594, P = 0.002 and R = 0.495, P = 0.012) and white women (R = −0.554, P = 0.005 and R = −0.546, P = 0.004), but with VAT in white women only (R = −0.534, P = 0.005). In conclusion, body fat distribution is differentially associated with insulin sensitivity in black and white women. Therefore, the different abdominal fat depots may have varying metabolic consequences in women of different ethnic origins.

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