Abstract
The prevalence of type 2 diabetes (T2D) has increased dramatically in Middle Eastern populations that represent the largest non-European immigrant group in Sweden today. As proneurotensin predicts T2D, the aim of this study was to investigate differences in proneurotensin levels across populations of Middle Eastern and Caucasian origin and to study its associations with indices of glucose regulation. Participants in the age 30 to 75 years, living in Malmö, Sweden, and born in Iraq or Sweden, were recruited from the census register. Anthropometrics and fasting samples were collected and oral glucose tolerance tests conducted assessing insulin secretion (DIo) as well as insulin sensitivity (ISI). A total of 2155 individuals participated in the study, 1398 were Iraqi-born and 757 were Swedish-born participants. Higher fasting proneurotensin levels were observed in Iraqi- compared to Swedish-born participants (137.5 vs. 119.8 pmol/L; p < 0.001) data adjusted for age, sex and body mass index. In Iraqi participants only, plasma proneurotensin was associated with impaired glucose regulation assessed as ISI, DIo and HbA1c, and significant interactions between country of birth and proneurotensin were observed (Pinteraction ISI = 0.048; Pinteraction DIo = 0.014; PinteractionHbA1c = 0.029). We report higher levels of proneurotensin in the general Middle Eastern population. The finding that Middle Eastern origin modifies the relationship of proneurotensin with indices of glucose regulation suggests that proneurotensin may be a stronger determinant of T2D in Middle Eastern as compared to Caucasian populations. These findings may explain part of the excess T2D risk in the Middle Eastern population but needs to be explored further.
Highlights
Type 2 diabetes (T2D) is one of the most challenging health problem of the 21st century
Our final study population included 1398 subjects born in Iraq (819 men, participation rate (PR) 45.9% and 579 women, PR 52.1%) and 757 subjects born in Sweden (400 men, PR 32.2%, and 357 women, PR 31.8%)
The level of proneurotensin as well as BMI were significantly higher amongst Iraqi-born as compared to Swedish-born participants, data adjusted for age and sex (Table 1)
Summary
Type 2 diabetes (T2D) is one of the most challenging health problem of the 21st century. Over 70 percent of the Iraqi immigrant population regularly eat traditional dishes, despite living in Sweden for more than two decades These traditional dishes contain high percentage of fat, that can contribute to insulin resistance and influence cardiometabolic risk biomarkers[3]. Prospective population-based studies of Caucasians, elevated plasma proneurotensin levels are strong and independent predictor of incident obesity, T2D, cardiovascular disease and premature mortality[9,10,11,13]. In this observational study, we hypothesized that proneurotensin may contribute to impaired glucose regulation and that the effect may differ across populations of Middle Eastern and Caucasian origins. To the best of our knowledge, studies investigating effect of plasma proneurotensin on glucose regulation comparing populations of different origin, in whom both diet and genetic backgrounds most likely differ, have not been previously explored
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