title: Circulating levels of TNF-α are associated with impaired glucose tolerance, increased insulin resistance, and ethnicity: the Insulin Resistance Atherosclerosis Study.
abstract: OBJECTIVE
  Although several epidemiological studies have investigated associations between TNF-α and insulin resistance, results have been inconsistent. We studied the relationship between TNF-α and glucose tolerance status as part of the Insulin Resistance Atherosclerosis Study.
  
  
  METHODS
  Serum concentrations of TNF-α were measured in 1558 individuals in a triethnic population across a spectrum of glucose tolerance. Insulin sensitivity and insulin secretion were assessed by a frequently sampled iv glucose tolerance test (FSIGT).
  
  
  RESULTS
  Compared with those with normal glucose tolerance, circulating levels of TNF-α were elevated in individuals with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2D) after adjusting for age, gender, ethnicity, clinic site, and body mass index (3.3, 3.5, and 3.7 pg/ml in subjects with normal glucose tolerance, IGT, and T2D, respectively; P<0.05). Age-, sex-, and body mass index-adjusted levels of TNF-α differed by ethnicity, with Hispanics having the highest levels and African-Americans having the lowest (4.1, 3.6, and 3.0 pg/ml in Hispanics, non-Hispanic whites, and African-Americans, respectively; P<0.05). TNF-α was correlated with waist circumference, high-density lipoprotein, triglycerides, plasminogen activator inhibitor-1 and insulin sensitivity index (SI) (r=0.22, -0.30, 0.35, 0.31, and -0.25; P<0.0001); however, correlations varied by ethnicity. After adjusting for demographics and adiposity, individuals characterized by increased insulin resistance (lower SI), had higher levels of TNF-α than subjects characterized by high insulin sensitivity (3.8 and 3.3 pg/ml in subjects with an SI below/above the median at baseline; P<0.0001). No differences were found for acute insulin response.
  
  
  CONCLUSIONS
  We confirm that TNF-α is associated with IGT and T2D in a large, multiethnic population, independent of measures of adiposity. Adjusted values of TNF-α, as well as relationships between TNF-α and variables related to T2D, varied by ethnicity. Increased TNF-α levels were predominantly associated with insulin resistance but not with primary defects in β-cell function.
authors.affiliation: Department of PathologyUniversity of Vermont College of Medicine, Burlington, VT 05405, USA.
authors.forename: Nels C
authors.initials: NC
authors.lastname: Olson
authors.forename: Peter W
authors.initials: PW
authors.lastname: Callas
authors.forename: Anthony J G
authors.initials: AJ
authors.lastname: Hanley
authors.forename: Andreas
authors.initials: A
authors.lastname: Festa
authors.forename: Steven M
authors.initials: SM
authors.lastname: Haffner
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
mesh_terms: D001741:Black or African American; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000503:physiopathology; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D044465:White People
chemical_list: D007328:Insulin; D014409:Tumor Necrosis Factor-alpha