Diabetes, Vol 42, Issue 3 444-449, Copyright © 1993 by American Diabetes Association
Do blacks with NIDDM have an insulin-resistance syndrome?
RL Chaiken, MA Banerji, H Huey and HE Lebovitz
Department of Medicine, State University of New York-Health Science Center at Brooklyn, Brooklyn 11203.
NIDDM has been postulated to be a component of a more generalized metabolic
syndrome, Syndrome X, caused by insulin resistance. Although the components
of the syndrome include glucose intolerance, hypertension, increased TG,
and decreased HDL cholesterol, their relationship to insulin resistance
and/or hyperinsulinemia is controversial. Recent investigations have shown
racial differences in the relationship between insulin resistance and BP in
nondiabetic populations. We assessed the relationship between insulin
resistance and the other components of the syndrome in 37 black men and 53
black women with NIDDM. Insulin sensitivity was determined by measuring
glucose disposal with the euglycemic insulin clamp technique with a 1
mU.kg-1.min-1 insulin infusion. We also determined fasting lipid profiles
and BP. In this group of black men and women with NIDDM, 30% were insulin
sensitive, and 70% were insulin resistant. No correlation existed between
insulin sensitivity and sBP or dBP in either sex. Fasting serum TGs were
inversely correlated with insulin sensitivity for both men (r = -0.401, P =
0.02) and women (r = -0.366, P = 0.008). Serum HDL cholesterol was highly
correlated with insulin sensitivity for men (r = 0.421, P = 0.01) but not
for women (r = 0.071, P = 0.62). Fasting serum TG levels and serum
HDL-cholesterol levels were highly correlated in an inverse relationship in
men (r = -0.368, P = 0.03), but not women (r = -0.199, P = 0.17). In
summary, BP does not correlate with insulin resistance in blacks with
NIDDM. Normal insulin sensitivity occurs in 33% of black men and 25% of
black women with NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)