title: Ethnic differences in insulin sensitivity and beta-cell function among Asian men.
abstract: OBJECTIVE
  Lean Asian Indians are less insulin sensitive compared with Chinese and Malays, but the pancreatic beta-cell function among these ethnic groups has yet to be studied in depth. We aimed to study beta-cell function in relation to insulin sensitivity among individuals of Chinese, Malay and Asian-Indian ethnicity living in Singapore.
  
  
  METHODS
  This is a sub-group analysis of 59 normoglycemic lean (body mass index (BMI) <23 kg m(-)(2)) adult males (14 Chinese, 21 Malays and 24 Asian Indians) from the Singapore Adults Metabolism Study. Insulin sensitivity was determined using fasting state indices (homeostatic model assessment-insulin resistance), the euglycemic-hyperinsulinemic clamp (ISI-clamp) and a liquid mixed-meal tolerance test (LMMTT) (Matsuda insulin sensitivity index (ISI-Mat)). Beta-cell function was assessed using fasting state indices (homeostatic model assessment-beta-cell function) and from the LMMTT (insulinogenic index and insulin secretion index). The oral disposition index (DI), a measure of beta-cell function relative to insulin sensitivity during the LMMTT, was calculated as a product of ISI-Mat and insulin secretion index.
  
  
  RESULTS
  Asian Indians had higher waist circumference and percent body fat than Chinese and Malays despite similar BMI. Overall, Asian Indians were the least insulin sensitive whereas the Chinese were most insulin sensitive. Asian Indians had higher beta-cell function compared with Chinese or Malays but these were not statistically different. Malays had the highest incremental area under the curve for glucose during LMMTT compared with Asian Indians and Chinese. However, there were no significant ethnic differences in the incremental insulin area under the curve. The oral DI was the lowest in Malays, followed by Asian Indians and Chinese.
  
  
  CONCLUSIONS
  Among lean Asians, Chinese are the most insulin sensitive whereas Asian Indians are the least insulin sensitive. However, Malays demonstrate higher postprandial glucose excursion with lower beta-cell response compare with Chinese or Asian Indians. The paths leading to type 2 diabetes mellitus might differ between these Asian ethnic groups.
authors.affiliation: 1] Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore [2] Department of Paediatric, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: V M H
authors.initials: VM
authors.lastname: Tan
authors.affiliation: 1] Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore [2] Department of Paediatric, Yong Loo Lin School of Medicine, National University of Singapore, Singapore [3] Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore.
authors.forename: Y S
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: K
authors.initials: K
authors.lastname: Venkataraman
authors.affiliation: 1] Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore [2] Division of Endocrinology, Department of Medicine, National University Health System, Singapore.
authors.forename: E Y H
authors.initials: EY
authors.lastname: Khoo
authors.affiliation: 1] Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore [2] Division of Endocrinology, Department of Medicine, National University Health System, Singapore [3] Duke-NUS Graduate Medical School, Singapore.
authors.forename: E S
authors.initials: ES
authors.lastname: Tai
authors.affiliation: 1] Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore [2] Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Y S
authors.initials: YS
authors.lastname: Chong
authors.affiliation: 1] Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore [2] Liggins Institute, Auckland, New Zealand.
authors.forename: P
authors.initials: P
authors.lastname: Gluckman
authors.affiliation: 1] Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore [2] Department of Endocrinology, Tan Tock Seng Hospital, Singapore.
authors.forename: M K S
authors.initials: MK
authors.lastname: Leow
authors.affiliation: 1] Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore [2] Division of Endocrinology, Department of Medicine, National University Health System, Singapore [3] Duke-NUS Graduate Medical School, Singapore.
authors.forename: C M
authors.initials: CM
authors.lastname: Khoo