Serum Insulin, Obesity, and the Incidence of Type 2 Diabetes in Black and White Adults: The Atherosclerosis Risk in Communities Study: 1987–1998

Details

• Personal Author:
  Brancati FL ; Burchfiel CM ; Carnethon MR ; Fortmann SP ; Palaniappan LP ; Brancati FL ; Burchfiel CM ; Carnethon MR ; Fortmann SP ; Palaniappan LP
• Description:
  OBJECTIVE: In this study, we tested the hypothesis that fasting serum insulin is higher in nonobese black adults than in white adults and that high fasting insulin predicts type 2 diabetes equally well in both groups. RESEARCH DESIGN AND METHODS: At the baseline examination (1987-1989) of the Atherosclerosis Risk in Communities Study, fasting insulin and BMI were measured in 13,416 black and white men and women without diabetes. Participants were examined at years 3, 6, and 9 for incident diabetes based on fasting glucose and American Diabetes Association criteria. RESULTS: Fasting insulin was 19.7 pmol/l higher among nonobese (BMI <30 kg/m2) black women compared with white women (race and obesity interaction term, P < 0.01). There were no differences among men. Among nonobese women, the relative risk for developing diabetes was similar between racial groups: 1.4 (95% CI 1.2-1.5) and 1.3 (1.2-1.4) per 60 pmol/l increase in insulin (P < 0.01) for black and white women, respectively (interaction term, P = 0.6). Findings were similar among men. Adjusting for established risk factors did not attenuate this association. CONCLUSIONS: Nonobese black women have higher fasting insulin levels than nonobese white women, and fasting insulin is an equally strong predictor of diabetes in both groups. These results suggest one mechanism to explain the excess incidence of diabetes in nonobese black women but do not explain the excess among black men. Future research should evaluate additional factors: genetic, environmental, or the combination of both, which might explain higher fasting insulin among black women when compared with white women. [Description provided by NIOSH]
• Subjects:
  Body Weight Endocrine System Endocrine System Diseases Men Occupational Health Race Factors Risk Assessment Risk Factors Safety Women
• Keywords:
  Body-weight Caloric-intake Endocrine-system Endocrine-system-disorders Physical-exercise Racial-factors Risk-factors Serological-techniques Sociological-factors Statistical-analysis Weight-factors Weight-measurement

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• ISSN:
  0149-5992
• Document Type:
  Text
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  California ; Maryland ; OSHA Region 3 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division ; HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Volume:
  25
• Issue:
  8
• NIOSHTIC Number:
  nn:20032181
• Citation:
  Diabetes Care 2002 Aug; 25(8):1358-1364
• Contact Point Address:
  Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Road, Palo Alto, CA 94304
• Email:
  carnethon@stanford.edu
• Federal Fiscal Year:
  2002
• Peer Reviewed:
  True
• Source Full Name:
  Diabetes Care
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e63aea5d3e823ada07c8ddab0e6ff374004a6545752044d46dd8d66f52c3a1cae882c5fd5f53cc2298aa2b422c227d7efb2d0ec1592c9a4a03d9641e45520bd2
• Download URL:
  https://stacks.cdc.gov/view/cdc/186223/cdc_186223_DS1.pdf
• File Type:
  [PDF - 153.50 KB ]