title: Insulin resistance is associated with a metabolic profile  of altered protein metabolism in Chinese  and Asian-Indian men.
abstract: OBJECTIVE
  Insulin resistance (IR) is associated with obesity, but can also develop in individuals with normal body weight. We employed comprehensive profiling methods to identify metabolic events associated with IR, while controlling for obesity.
  
  
  METHODS
  We selected 263 non-obese (BMI approximately 24 kg/m2) Asian-Indian and Chinese men from a large cross-sectional study carried out in Singapore. Individuals taking medication for diabetes or hyperlipidaemia were excluded. Participants were separated into lower and upper tertiles of IR based on HOMA indices of < or =1.06 or > or =1.93, respectively. MS-based metabolic profiling of acylcarnitines, amino acids and organic acids was combined with hormonal and cytokine profiling in all participants.
  
  
  RESULTS
  After controlling for BMI, commonly accepted risk factors for IR, including circulating fatty acids and inflammatory cytokines, did not discriminate the upper and lower quartiles of insulin sensitivity in either Asian- Indian or Chinese men. Instead, IR was correlated with increased levels of alanine, proline, valine, leucine/isoleucine, phenylalanine, tyrosine, glutamate/glutamine and ornithine, and a cluster of branched-chain and related amino acids identified by principal components analysis. These changes were not due to increased protein intake by individuals in the upper quartile of IR. Increased abdominal adiposity and leptin, and decreased adiponectin and IGF-binding protein 1 were also correlated with IR.
  
  
  CONCLUSIONS
  These findings demonstrate that perturbations in amino acid homeostasis, but not inflammatory markers or NEFAs, are associated with IR in individuals of relatively low body mass.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: E S
authors.initials: ES
authors.lastname: Tai
authors.forename: M L S
authors.initials: ML
authors.lastname: Tan
authors.forename: R D
authors.initials: RD
authors.lastname: Stevens
authors.forename: Y L
authors.initials: YL
authors.lastname: Low
authors.forename: M J
authors.initials: MJ
authors.lastname: Muehlbauer
authors.forename: D L M
authors.initials: DL
authors.lastname: Goh
authors.forename: O R
authors.initials: OR
authors.lastname: Ilkayeva
authors.forename: B R
authors.initials: BR
authors.lastname: Wenner
authors.forename: J R
authors.initials: JR
authors.lastname: Bain
authors.forename: J J M
authors.initials: JJ
authors.lastname: Lee
authors.forename: S C
authors.initials: SC
authors.lastname: Lim
authors.forename: C M
authors.initials: CM
authors.lastname: Khoo
authors.forename: S H
authors.initials: SH
authors.lastname: Shah
authors.forename: C B
authors.initials: CB
authors.lastname: Newgard
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D000596:Amino Acids / Q000097:blood / Q000378:metabolism; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003710:Demography; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D007194:India; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007378:Interleukins / Q000097:blood; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D018579:Patient Selection; D044469:Racial Groups; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D044465:White People
chemical_list: D052242:Adiponectin; D000596:Amino Acids; D001786:Blood Glucose; D007328:Insulin; D018969:Insulin-Like Growth Factor Binding Proteins; D007378:Interleukins; D008055:Lipids; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D002784:Cholesterol