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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #363702
Title: Gluconeogenesis and risk for fasting hyperglycemia in Black and White women

Author
item CHUNG, STEPHANIE - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item COURVILLE, AMBER - NATIONAL INSTITUTES OF HEALTH (NIH)
item ONUZURUIKE, ANTHONY - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item GALVAN-DE LA CRUZ, MIRELLA - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item MABUNDO, LILIAN - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item DUBOSE, CHRISTOPHER - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item KASTURI, KANNAN - NATIONAL INSTITUTES OF HEALTH (NIH)
item CAI, HONGYI - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item GHARIB, AHMED - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item WALTER, PETER - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item GARRAFFO, H - NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES
item CHACKO, SHAJI - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item HAYMOND, MOREY - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item SUMMER, ANNE - NATIONAL INSTITUTES OF HEALTH (NIH)

Submitted to: Journal of Clinical Investigation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/14/2018
Publication Date: 9/20/2018
Citation: Chung, S.T., Courville, A.B., Onuzuruike, A.U., Galvan-De La Cruz, M., Mabundo, L.S., Dubose, C.W., Kasturi, K., Cai, H., Gharib, A.M., Walter, P.J., Garraffo, H.M., Chacko, S., Haymond, M.W., Summer, A.E. 2018. Gluconeogenesis and risk for fasting hyperglycemia in Black and White women. Journal of Clinical Investigation. 3(18):e121495. https://doi.org/10.1172/jci.insight.121495.
DOI: https://doi.org/10.1172/jci.insight.121495

Interpretive Summary: High rates of undiagnosed Type 2 diabetes remain prevalent in women of African ancestry. However, high fasting blood glucose concentration and fatty liver are uncommon early pathological features of their abnormal blood glucose condition. The objective of this study was to elucidate the mechanisms underlying the lower prevalence of high fasting blood glucose in Black women. This study demonstrated that glucose production in liver was lower in Black women compared with White women. We have shown that there are racial differences in the physiological mechanisms that may contribute to the development of high fasting blood glucose concentration. The lower rates of glucose production in the liver among Black women may explain why using fasting blood glucose concentration alone could contribute to lower early diagnosis among this population. Alternative and combination strategies, such as combining fasting blood glucose concentration with HbA1c tests, may be useful for early diagnosis and in improving the intervention programs in individuals of African ancestry.

Technical Abstract: Black women, compared with White women, have high rates of whole-body insulin resistance but a lower prevalence of fasting hyperglycemia and hepatic steatosis. This dissociation of wholebody insulin resistance from fasting hyperglycemia may be explained by racial differences in gluconeogenesis, hepatic fat, or tissue-specific insulin sensitivity. Two groups of premenopausal federally employed women, without diabetes were studied. Using stable isotope tracers, [2H2O] and [6,62-H2]glucose, basal glucose production was partitioned into its components (gluconeogenesis and glycogenolysis) and basal whole-body lipolysis ([2H5]glycerol) was measured. Indices of insulin sensitivity, whole-body (SI), hepatic (HISIGPR), and adipose tissue, were calculated. Hepatic fat was measured by proton magnetic resonance spectroscopy. Black women had less hepatic fat and lower fractional and absolute gluconeogenesis. Whole-body SI, HISIGPR, and adipose tissue sensitivity were similar by race, but at any given level of whole-body SI, Black women had higher HISIGPR. Therefore, fasting hyperglycemia may be a less common early pathological feature of prediabetes in Black women compared with White women, because gluconeogenesis remains lower despite similar whole-body SI.