Black African men with early type 2 diabetes have similar muscle, liver and adipose tissue insulin sensitivity to white European men despite lower visceral fat

Oluwatoyosi Bello, Cynthia Mohandas, Fariba Shojee-Moradie, Nicola Jackson, Olah Hakim, K George M M Alberti, Janet L Peacock, A Margot Umpleby, Stephanie A Amiel, Louise M Goff

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AIMS/HYPOTHESIS: Type 2 diabetes is more prevalent in black African than white European populations although, paradoxically, black African individuals present with lower levels of visceral fat, which has a known association with insulin resistance. Insulin resistance occurs at a tissue-specific level; however, no study has simultaneously compared whole body, skeletal muscle, hepatic and adipose tissue insulin sensitivity between black and white men. We hypothesised that, in those with early type 2 diabetes, black (West) African men (BAM) have greater hepatic and adipose tissue insulin sensitivity, compared with white European men (WEM), because of their reduced visceral fat.METHODS: Eighteen BAM and 15 WEM with type 2 diabetes underwent a two-stage hyperinsulinaemic-euglycaemic clamp with stable glucose and glycerol isotope tracers to assess tissue-specific insulin sensitivity and a magnetic resonance imaging scan to assess body composition.RESULTS: We found no ethnic differences in whole body, skeletal muscle, hepatic or adipose tissue insulin sensitivity between BAM and WEM. This finding occurred in the presence of lower visceral fat in BAM (3.72 vs 5.68 kg [mean difference -1.96, 95% CI -3.30, 0.62]; p = 0.01). There was an association between skeletal muscle and adipose tissue insulin sensitivity in WEM that was not present in BAM (r = 0.78, p < 0.01 vs r = 0.25 p = 0.37).

CONCLUSIONS/INTERPRETATION: Our data suggest that in type 2 diabetes there are no ethnic differences in whole body, skeletal muscle, hepatic and adipose tissue insulin sensitivity between black and white men, despite differences in visceral adipose tissue, and that impaired lipolysis may not be contributing to skeletal muscle insulin resistance in men of black African ethnicity.

© 2021, The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See
Original languageEnglish
Pages (from-to)835-844
Number of pages10
Issue number5
Publication statusPublished - 6 Feb 2019


  • Adolescent
  • Adult
  • Africa/epidemiology
  • African Continental Ancestry Group
  • Aged
  • Area Under Curve
  • Body Composition
  • Diabetes Mellitus, Type 2/ethnology
  • European Continental Ancestry Group
  • Glucose Clamp Technique
  • Humans
  • Insulin/metabolism
  • Insulin Resistance
  • Intra-Abdominal Fat/metabolism
  • Liver/metabolism
  • London
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Muscle, Skeletal/metabolism
  • Obesity/metabolism
  • Young Adult

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