Abstract
BackgroundLatinos in the United States have a higher prevalence of type 2 diabetes than non-Latino whites, even after controlling for adiposity. Decreased adiponectin is associated with insulin resistance and predicts T2DM, and therefore may mediate this ethnic difference. We compared total and high-molecular-weight (HMW) adiponectin in Latino versus white individuals, identified factors associated with adiponectin in each ethnic group, and measured the contribution of adiponectin to ethnic differences in insulin resistance.MethodsWe utilized cross-sectional data from subjects in the Latinos Using Cardio Health Actions to reduce Risk study. Participants were Latino (n = 119) and non-Latino white (n = 60) men and women with hypertension and at least one other risk factor for CVD (age 61 ± 10 yrs, 49% with T2DM), seen at an integrated community health and hospital system in Denver, Colorado. Total and HMW adiponectin was measured by RIA and ELISA respectively. Fasting glucose and insulin were used to calculate the homeostasis model insulin resistance index (HOMA-IR). Variables independently associated with adiponectin levels were identified by linear regression analyses. Adiponectin's contribution to ethnic differences in insulin resistance was assessed in multivariate linear regression models of Latino ethnicity, with logHOMA-IR as a dependent variable, adjusting for possible confounders including age, gender, adiposity, and renal function.ResultsMean adiponectin levels were lower in Latino than white patients (beta estimates: -4.5 (-6.4, -2.5), p < 0.001 and -1.6 (-2.7, -0.5), p < 0.005 for total and HMW adiponectin), independent of age, gender, BMI/waist circumference, thiazolidinedione use, diabetes status, and renal function. An expected negative association between adiponectin and waist circumference was seen among women and non-Latino white men, but no relationship between these two variables was observed among Latino men. Ethnic differences in logHOMA-IR were no longer observed after controlling for adiponectin levels.ConclusionsAmong patients with CVD risk, total and HMW adiponectin is lower in Latinos, independent of adiposity and other known regulators of adiponectin. Ethnic differences in adiponectin regulation may exist and future research in this area is warranted. Adiponectin levels accounted for the observed variability in insulin resistance, suggesting a contribution of decreased adiponectin to insulin resistance in Latino populations.
Highlights
Latinos in the United States have a higher prevalence of type 2 diabetes than non-Latino whites, even after controlling for adiposity
In regards to medication use, TZD use was higher and ASA use was lower in Latino men compared to white men, but use of angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin receptor blockers (ARB) and statin was not different in the two ethnic groups
In the present study, we found decreased total and HMW adiponectin levels in Latino compared to non-Latino white patients with cardiovascular disease (CVD) risk
Summary
Latinos in the United States have a higher prevalence of type 2 diabetes than non-Latino whites, even after controlling for adiposity. Latinos in the United States have a higher incidence and prevalence of insulin resistance, and type 2 diabetes mellitus [1,2], compared to non-Latino whites. Though this observation has been attributed, at least in part, to a higher rate of obesity in Latinos [1], insulin resistance and type 2 diabetes are more prevalent in Latinos compared to whites even after controlling for weight differences [1,3,4,5]. Associations with other factors including use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) [23], acetylsalicylic acid [24], and statins [25] remain controversial
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