Racial differences in insulin resistance and mid-thigh fat deposition in postmenopausal women.

OBJECTIVE: To determine whether racial differences in insulin resistance between African American (AA) and white women exist in postmenopausal women and whether they are related to physical fitness and/or obesity. RESEARCH METHODS AND PROCEDURES: We studied 35 obese AA (n = 9) and white (n = 26) women of comparable maximal oxygen consumption, obesity, and age. Total body fat was measured by DXA. Abdominal and mid-thigh low-density lean tissue (a marker of intramuscular fat) were determined with computed tomography. Glucose utilization (M) was measured during the last 30 minutes of a 3-hour hyperinsulinemic-euglycemic clamp. Insulin sensitivity was estimated from the relationship of M to the concentration of insulin during the last 30 minutes of the clamp.
RESULTS: The percentage of fat and total body fat mass were similar between AA and white women, whereas fat-free mass was higher in African American women. Visceral adipose tissue was not different between groups, but subcutaneous abdominal fat was 17% higher in the AA than in the white women. AA women had an 18% greater mid-thigh muscle area (p < 0.01) and a 34% greater mid-thigh low-density lean tissue area than the white women. Fasting glucose concentrations were not different, but fasting insulin concentrations were 29% higher in AA women. Glucose utilization was 60% lower in the AA women because of a lower non-oxidative glucose disposal. Insulin sensitivity was 46% lower in the AA women. DISCUSSION: AA postmenopausal women have more mid-thigh intramuscular fat, lower glucose utilization, and are less insulin sensitive than white women despite comparable fitness and relative body fat levels.