Journal of Diabetes Medication & Care

Ethnic Differences In Inflammatory

 Obesity is closely linked to the development of diabetes, cardiovascular disease and cancer, and also related to chronic systemic low-grade inflammation marked by altered circulating levels of adipokine and inflammatory markers. Thus, adipose tissue, consisting of adipocytes, immune cells and nerve/ connective tissue, is now recognized as an important endocrine and metabolically active organ. The pro-inflammatory phenotype associated with excess fat mass results in low production of adiponectin and high production of leptin, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Interestingly, the pro-inflammatory response appears to differ depending on body fat distribution. Because visceral adipose tissue (VAT) surrounds the internal organs and is more vascular and metabolically active than subcutaneous adipose tissue (SAT), VAT accumulation is thought to be more health hazardous—that is, increased risks of insulin resistance and related metabolic diseases—than abdominal or peripheral SAT. Central adiposity differs by sex and ethnicity, in particular Asian ethnicity is associated with higher VAT and African American (AA) ethnicity with lower VAT relative to whites. These variations in adipose tissue composition appear to be linked to ethnic disparities in obesity-related chronic diseases, such as higher rates of diabetes among Japanese Americans (JA) or AA at similar body mass index (BMI) levels. The hypothesis is that differences in circulating adipokines and inflammatory markers as a result of ethnic differences in the distribution of adipose tissue are partially responsible for these ethnic disparities in obesity-related disease risk.   

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