Sequeira Ivana R, Yip Wilson C, Lu Louise W W, Jiang Yannan, Murphy Rinki, Plank Lindsay D, Cooper Garth J S, Peters Carl N, Lu Jun, Hollingsworth Kieren G, Poppitt Sally D
Human Nutrition Unit, Faculty of Science, School of Biological Sciences, University of Auckland, Auckland, New Zealand.
High Value Nutrition National Science Challenge, Auckland, New Zealand.
Front Physiol. 2022 Mar 31;13:819606. doi: 10.3389/fphys.2022.819606. eCollection 2022.
Prevalence of type 2 diabetes (T2D) is disproportionately higher in younger outwardly lean Asian Chinese compared to matched Caucasians. Susceptibility to T2D is hypothesised due to dysfunctional adipose tissue expansion resulting in adverse abdominal visceral and organ fat accumulation. Impact on early risk, particularly in individuals characterised by the thin-on-the-outside-fat-on-the-inside (TOFI) phenotype, is undetermined.
Sixty-eight women [34 Chinese, 34 Caucasian; 18-70 years; body mass index (BMI), 20-45 kg/m] from the TOFI_Asia study underwent magnetic resonance imaging and spectroscopy to quantify visceral, pancreas, and liver fat. Total body fat was (TBF) assessed by dual-energy x-ray absorptiometry, and fasting blood biomarkers were measured. Ethnic comparisons, conducted using two-sample tests and multivariate regressions adjusted for age, % TBF and ethnicity, identified relationships between abdominal ectopic fat depots with fasting plasma glucose (FPG), insulin resistance (HOMA2-IR), and related metabolic clinical risk markers in all, and within ethnic groups.
Despite being younger and of lower bodyweight, Chinese women in the cohort had similar BMI and % TBF compared to their Caucasian counterparts. Protective high-density lipoprotein cholesterol, total- and high-molecular weight adiponectin were significantly lower, while glucoregulatory glucagon-like peptide-1 and glucagon significantly higher, in Chinese. There were no ethnic differences between % pancreas fat and % liver fat. However, at low BMI, % pancreas and % liver fat were ∼1 and ∼2% higher in Chinese compared to Caucasian women. In all women, % pancreas and visceral adipose tissue had the strongest correlation with FPG, independent of age and % TBF. Percentage (%) pancreas fat and age positively contributed to variance in FPG, whereas % TBF, amylin and C-peptide contributed to IR which was 0.3 units higher in Chinese.
Pancreas fat accumulation may be an early adverse event, in TOFI individuals, with peptides highlighting pancreatic dysfunction as drivers of T2D susceptibility. Follow-up is warranted to explore causality.
与相匹配的高加索人相比，外表消瘦的年轻华裔亚洲人2型糖尿病（T2D）患病率异常高。由于脂肪组织扩张功能失调导致腹部内脏和器官脂肪不良堆积，推测其对T2D易感性有影响。对早期风险的影响，尤其是对具有外瘦内胖（TOFI）表型个体的影响尚不确定。
来自TOFI_Asia研究的68名女性[34名华裔、34名高加索人；年龄18 - 70岁；体重指数（BMI），20 - 45 kg/m²]接受了磁共振成像和波谱分析，以量化内脏、胰腺和肝脏脂肪。通过双能X线吸收法评估全身脂肪（TBF），并测量空腹血液生物标志物。使用双样本检验和针对年龄、TBF百分比和种族进行调整的多变量回归进行种族比较，确定了所有人群以及不同种族群体中腹部异位脂肪堆积与空腹血糖（FPG）、胰岛素抵抗（HOMA2 - IR）以及相关代谢临床风险标志物之间的关系。
尽管该队列中的华裔女性更年轻且体重更低，但与高加索女性相比，她们的BMI和TBF百分比相似。华裔女性中具有保护作用的高密度脂蛋白胆固醇、总脂联素和高分子量脂联素显著较低，而调节血糖的胰高血糖素样肽 - 1和胰高血糖素则显著较高。胰腺脂肪百分比和肝脏脂肪百分比在种族之间没有差异。然而，在低BMI时，华裔女性的胰腺脂肪百分比和肝脏脂肪百分比比高加索女性分别高约1%和2%。在所有女性中，胰腺脂肪百分比和内脏脂肪组织与FPG的相关性最强，不受年龄和TBF百分比影响。胰腺脂肪百分比（%）和年龄对FPG的方差有正向贡献，而TBF百分比、胰淀素和C肽对胰岛素抵抗有贡献，华裔女性的胰岛素抵抗比高加索女性高0.3个单位。
在TOFI个体中，胰腺脂肪堆积可能是早期不良事件，肽类物质突出了胰腺功能障碍是T2D易感性的驱动因素。有必要进行随访以探究因果关系。
