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Title: Ethnic differences in glucose homeostasis markers between the Kyushu-Okinawa Population Study and the Framingham Offspring Study

Author
item IZEZAKI, HIROAKI - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item AI, MASUMI - Tokyo Medical And Dental University
item SCHAEFER, ERNST - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item OTOKOZAWA, SEIKO - Sapporo Medical University
item ASZTLOS, BELA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item NAKAJIMA, KATSUYUKI - Gunma University
item ZHOU, YANHUA - Boston University
item LIU, CHING-TI - Boston University
item JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item CUPPLES, L - Boston University
item FURUSYO, NORIHIRO - Kyushu University

Submitted to: Scientific Reports
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/20/2016
Publication Date: 11/10/2016
Citation: Izezaki, H., Ai, M., Schaefer, E., Otokozawa, S., Asztlos, B.F., Nakajima, K., Zhou, Y., Liu, C., Jacques, P.F., Cupples, L.A., Furusyo, N. 2016. Ethnic differences in glucose homeostasis markers between the Kyushu-Okinawa Population Study and the Framingham Offspring Study. Scientific Reports. 6:36725. https://doi.org/10.1038/srep36725.
DOI: https://doi.org/10.1038/srep36725

Interpretive Summary: Research has suggested that diabetes prevalence is higher among Asian populations than Caucasians. Blood sugar, primarily glucose, is tightly regulated by the body through a process called glucose homeostasis. The body uses glucose for energy; however, glucose levels that are too high can result in diabetes. With type 2 diabetes, the body's ability to produce or respond to the hormone insulin becomes impaired (insulin resistance), and this allows glucose levels to rise too high. We hypothesized that there may be ethnic differences in the relationship between glucose and insulin. Thus, the goal of this study was to compare glucose and insulin levels among individuals in Fukuoka, Japan and age- and gender-matched individuals in a Caucasian population, the Framingham Heart Study (FHS). Impaired fasting glucose (IFG) is characterized by blood sugar levels above the normal range, which is indicative of prediabetes. Our results showed that IFG prevalence in Japanese men and women was 50% less than those observed in Framingham men and women. Despite this, the prevalence of diabetes in Japanese men was twice as high as the prevalence in Caucasian men. Diabetes prevalence in Japanese and Caucasian women was similar. Insulin levels in Japanese men and women were significantly lower than insulin levels in Caucasians, thus suggesting that insulin deficiency may be a driving factor for diabetes in Japan. In conclusion, our data indicate that there is significantly lower impaired fasting glucose and lower insulin levels, but higher diabetes prevalence, in Japanese men than in Caucasian men, indicating that insulin deficiency may be an important cause of diabetes in Japan. This information can help to inform therapies that may be more effective in managing diabetes in Japanese populations.

Technical Abstract: We compared markers of glucose homeostasis and their association with diabetes and impaired fasting glucose (IFG) in Fukuoka, Japanese subjects (n=1108) and age-, gender- and menopausal status-matched participants in the Framingham Offspring Study (n=1096). The markers examined included fasting glucose, insulin, adiponectin, and glycated albumin, as well as body mass index (BMI), use of medications, and history of diabetes. The results showed that IFG prevalence in Japanese men (15.9%) and women (7.4%) were 50% less than those observed in Framingham men (34.5%) and women (21.4%) (P< 0.001). However, the diabetes prevalence in Japanese men at 13.3% was twice as high (P<0.01) as the rate in Framingham men at 6.5%, while these rates were similar in women. Median insulin levels in Japanese men (4.6 muIU/mL) and women (4.3 muIU/mL) were about 50% lower (P<0.001) than those in Framingham men (10.8 muIU/mL) and women (9.9 muIU/mL), as were insulin resistance values (P<0.001). These population differences were also observed after subjects were stratified by glucose levels. In conclusion, our data indicate that there is significantly less IFG, lower insulin levels, and insulin resistance, but higher diabetes prevalence in Fukuoka men than in Framingham men, indicating that insulin deficiency may be an important cause of diabetes in Japan.