Parvaresh Rizi Ehsan, Teo Yvonne, Leow Melvin Khee-Shing, Venkataraman Kavita, Khoo Eric Yin Hao, Yeo Chia Rou, Chan Edmund, Song Tammy, Sadananthan Suresh Anand, Velan S Sendhil, Gluckman Peter D, Lee Yung Seng, Chong Yap Seng, Tai E Shyong, Toh Sue-Anne, Khoo Chin Meng
Department of Medicine (E.P.R., Y.T., E.Y.H.K., C.R.Y., E.C., T.S., E.S.T., S.-A.T., C.M.K.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597; Department of Medicine (E.P.R., E.Y.H.K., E.S.T., S.-A.T., C.M.K.), National University Health System, Singapore 119228; Duke-National University of Singapore Graduate Medical School (E.S.T., S.-A.T., C.M.K.), Singapore 169857; Department of Endocrinology (M.K.-S.L.), Tan Tock Seng Hospital, Singapore 308433; Singapore Institute for Clinical Sciences (A*STAR) (M.K.-S.L., S.A.S., S.S.V., P.D.G., Y.S.L.), Brenner Centre for Molecular Medicine, Singapore 117609; Department of Obstetrics & Gynaecology (S.A.S., Y.S.C.), National University of Singapore, Singapore 119077; Singapore Bioimaging Consortium (S.S.V.), A*STAR, Singapore 138667; Clinical Imaging Research Centre (S.S.V.), A*STAR-NUS, Singapore 119077; and Department of Paediatrics (Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597.
J Clin Endocrinol Metab. 2015 Nov;100(11):4249-56. doi: 10.1210/jc.2015-2639. Epub 2015 Aug 26.
Among Asian ethnic groups, Chinese or Malays are more insulin sensitive than South Asians, in particular in lean individuals. We have further reported that body fat partitioning did not explain this ethnic difference in insulin sensitivity.
We examined whether adipocytokines might explain the ethnic differences in the relationship between obesity and insulin resistance among the three major ethnic groups in Singapore.
This was a cross-sectional study of 101 Chinese, 82 Malays, and 81 South Asian men. Insulin sensitivity index (ISI) was measured using hyperinsulinemic euglycemic clamp. Visceral (VAT) and subcutaneous adipose tissue (SAT) volumes were quantified using magnetic resonance imaging.
Plasma total and high-molecular-weight adiponectin, leptin, visfatin, apelin, IL-6, fibroblast growth factor 21 (FGF21), retinol binding protein-4 (RBP 4), and resistin were measured using enzyme-linked immunoassays.
Principle component (PC) analysis on the adipocytokines identified three PCs, which explained 49.5% of the total variance. Adiponectin loaded negatively, and leptin and FGF21 loaded positively onto PC1. Visfatin, resistin, and apelin all loaded positively onto PC2. IL-6 loaded positively and RBP-4 negatively onto PC3. Only PC1 was negatively associated with ISI in all ethnic groups. In the path analysis, SAT and VAT were negatively associated with ISI in Chinese and Malays without significant mediatory role of PC1. In South Asians, the relationship between VAT and ISI was mediated partly through PC1, whereas the relationship between SAT and ISI was mediated mainly through PC1.
The relationships between abdominal obesity, adipocytokines and insulin sensitivity differ between ethnic groups. Adiponectin, leptin, and FGF21 play a mediating role in the relationship between abdominal adiposity and insulin resistance in South Asians, but not in Malays or Chinese.
在亚洲族群中，华裔或马来人比南亚人对胰岛素更敏感，尤其是在体型偏瘦的个体中。我们进一步报告称，身体脂肪分布并不能解释这种胰岛素敏感性的族群差异。
我们研究了脂肪细胞因子是否可以解释新加坡三大主要族群中肥胖与胰岛素抵抗关系的族群差异。
这是一项对101名华裔、82名马来人和81名南亚男性的横断面研究。使用高胰岛素正常血糖钳夹技术测量胰岛素敏感性指数（ISI）。使用磁共振成像对内脏（VAT）和皮下脂肪组织（SAT）体积进行定量。
使用酶联免疫吸附测定法测量血浆总脂联素和高分子量脂联素、瘦素、内脂素、Apelin、白细胞介素-6（IL-6）、成纤维细胞生长因子21（FGF21）、视黄醇结合蛋白4（RBP 4）和抵抗素。
对脂肪细胞因子进行主成分（PC）分析确定了三个主成分，它们解释了总方差的49.5%。脂联素在PC1上呈负负荷，瘦素和FGF21在PC1上呈正负荷。内脂素、抵抗素和Apelin在PC2上均呈正负荷。IL-6在PC3上呈正负荷，RBP-4在PC3上呈负负荷。在所有族群中，只有PC1与ISI呈负相关。在路径分析中，SAT和VAT与华裔和马来人的ISI呈负相关，PC1无显著中介作用。在南亚人中，VAT与ISI之间的关系部分通过PC1介导，而SAT与ISI之间的关系主要通过PC1介导。
腹部肥胖、脂肪细胞因子与胰岛素敏感性之间的关系在不同族群中存在差异。脂联素、瘦素和FGF21在南亚人腹部肥胖与胰岛素抵抗的关系中起中介作用，但在马来人或华裔中不起作用。
