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Public release date: 29 February 2008
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Mayo researchers look for explanation behind high incidence of diabetes
among Asian indians
ROCHESTER, Minn. — The incidence of type 2 diabetes is rising,
especially in urbanized parts of the world where sedentary lifestyles and
obesity abound. In addition to weight and inactivity, race puts some
people at increased risk for developing type 2 diabetes. The incidence
of diabetes is rapidly increasing globally, and Asian Indians have the
highest prevalence. An estimated 32 million Asian Indians have been
diagnosed with this condition, and some experts expect this number to
double over the next 30 years. In a study published in the March issue of
Diabetes, Mayo researchers examined whether Asian Indians have observable
differences in the way their cells convert nutrient fuel to available
energy and whether these differences may increase the risk for
diabetes.
"We know that Asian Indians are highly susceptible to this condition,
and they often acquire the disease at an earlier age and at lower body
mass index than people of European origin," explains Mayo
endocrinologist K. Sreekumaran Nair, M.D., Ph.D., the study's lead researcher. "The
question we asked is whether any metabolic differences between Asian
Indians and Americans of Northern European origin can explain the higher
incidence of diabetes in Indians."
Once known as adult-onset or non-insulin-dependent diabetes, type 2
diabetes is a chronic condition that affects the way the body utilizes
sugar (glucose). People with type 2 diabetes don't produce enough insulin
— a hormone that regulates the absorption of sugar into cells
— and their cells resist the effects of insulin (insulin-resistant).
While death rates due to heart attack, stroke and even cancer are
decreasing, deaths related to diabetes are increasing. Type 2 diabetes is
the leading cause of cardiovascular deaths, kidney failure, blindness,
sexual dysfunction and many other chronic complications.
Mayo researchers studied 13 diabetic Indians, 13 nondiabetic Indians,
and 13 nondiabetic northeast Americans of European descent who were
matched for gender, age and body mass to Indian study participants. Study
participants were fed the same diet and underwent tests for insulin
resistance and muscle biopsy to see whether differences occurred at the
cellular level among the different study subject groups.
The study yielded a number of interesting findings. Researchers
observed that the Indian subjects, irrespective of their diabetic status, had
a greater degree of insulin resistance than the American subjects of
Northern European origin, even though the study subjects were not obese,
a condition commonly associated with insulin resistance. Earlier
research has established that people with insulin resistance typically have
poorly functioning muscle mitochondria. Mitochondria are the part of
cells responsible for converting energy from nutrients to ATP (adenosine
triphosphate), the chemical form of cellular energy that the body uses
for almost all functions.
"Our study showed that the Indian diabetic and nondiabetic subjects
with insulin resistance actually had mitochondrial function that was
higher than those observed in the Northern European American subjects," says
Dr. Nair.
Dr. Nair hypothesizes that key to understanding this difference may lie
in an examination of how populations adapt as they become more
urbanized. Urban societies typically move away from lifestyles that involve a
higher level of physical activity and diets dominated by low-calorie
foods.
"The higher capacity to produce ATP that the Indian subjects displayed
may have been an adaptive advantage for the generations that preceded
them, when energy content of their diet was lower. But today, this trait
may be a disadvantage given the higher energy content of their current
diets," explains Dr. Nair.
Dr. Nair and his team are hopeful that the information gained from this
study will have a substantial impact on understanding the cause of the
global epidemic in diabetes.
"Our findings have potential to help determine the energy requirements
of different populations and what role this plays in the onset of
diabetes" says Dr. Nair.
Other authors of this article are: Maureen Bigelow; Yan Asmann, Ph.D.;
Lisa Chow; Jill Coenen-Schimke; Katherine Klaus; ZengKui Guo, Ph.D.;
Raghavakaimal Sreekumar; and Brian Irving, Ph.D.
http://www.mayoclinic.org/news2008-rst/4686.html?src=email-release
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