Ethnic Differences in Adipose Tissue Dysfunction in the Development of Insulin Resistance and Type 2 Diabetes (ADIT2D)

June 25, 2026 updated by: DR ADELE COSTABILE, University of Roehampton

Ethnic Differences in the Role of Adipose Tissue Dysfunction in the Development of Type 2 Diabetes

This pilot study investigates the relationship between type 2 diabetes (T2D) and adipose tissue dysfunction across different ethnic groups. Adipose tissue dysfunction is characterised by abnormal fat distribution, including increased visceral, hepatic, and pancreatic fat, elevated inflammatory biomarkers, and impaired metabolic function.

T2D is a chronic metabolic disease characterised by insulin resistance and disrupted glucose regulation. In the UK, its prevalence is significantly higher among South Asian and Black African/Caribbean populations than among White Europeans. Differences in adipose tissue distribution, particularly increased visceral fat accumulation, are thought to contribute to this disparity. Adipose tissue dysfunction, including chronic inflammation and altered adipokine secretion, is also associated with the development and progression of T2D.

Previous studies have identified ethnic differences in body fat distribution and metabolic risk. Genetic factors influencing adipose tissue function may partly explain variations in fat storage and susceptibility to T2D across populations. However, the specific contribution of adipose tissue dysfunction to ethnic differences in T2D risk remains unclear.

Evidence suggests that South Asians tend to have higher levels of liver and ectopic fat and a reduced capacity for safe subcutaneous fat storage, leading to fat accumulation in metabolically harmful sites. These characteristics are associated with increased insulin resistance and T2D risk. In contrast, Black populations often exhibit lower levels of visceral fat but still experience a high prevalence of T2D, indicating that factors beyond fat quantity may contribute to disease risk.

Despite extensive research on ethnic disparities in metabolic health, few studies have directly compared markers of adipose tissue dysfunction across South Asian, Black African/Caribbean, and White European populations within a single study. This study aims to address this gap and improve understanding of the mechanisms linking adipose tissue dysfunction, insulin resistance, and T2D. The findings may help inform more targeted prevention and treatment strategies for ethnically diverse populations in the UK.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

References:

  1. Amati, F., Pennant, M., Azuma, K., Dubé, J.J., Toledo, F.G.S., Rossi, A.P., Kelley, D.E. and Goodpaster, B.H. (2012). Lower Thigh Subcutaneous and Higher Visceral Abdominal Adipose Tissue Content Both Contribute to Insulin Resistance. Obesity, 20(5), pp.1115-1117. doi:https://doi.org/10.1038/oby.2011.401.
  2. Goff, L M. "Ethnicity and Type 2 diabetes in the UK." Diabetic medicine : a journal of the British Diabetic Association vol. 36,8 (2019): 927-938. doi:10.1111/dme.13895
  3. Iliodromiti, S. et al. (2023) "Liver, visceral and subcutaneous fat in men and women of South Asian and White European descent: A systematic review and meta-analysis of new and published data," Diabetologia, 66(1), pp. 44-56. Available at: https://doi.org/10.1007/s00125-022-05803-5.
  4. Lauro, D. et al. (1998) 'Impaired glucose tolerance in mice with a targeted impairment of insulin action in muscle and adipose tissue', Nature Genetics, 20(3), p. 294. doi:10.1038/3112.
  5. Unamuno, X., Gómez-Ambrosi, J., Rodríguez, A., Becerril, S., Frühbeck, G. and Catalán, V. (2018). Adipokine dysregulation and adipose tissue inflammation in human obesity. European Journal of Clinical Investigation, 48(9), p.e12997. doi:https://doi.org/10.1111/eci.12997.
  6. Yaghootkar, H et al. "Ethnic differences in adiposity and diabetes risk - insights from genetic studies." Journal of internal medicine vol. 288,3 (2020): 271-283. doi:10.1111/joim.13082

Study Type

Observational

Enrollment (Actual)

39

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United Kingdom
      • London, United Kingdom, SW145JD
        • Adele Costabile
    • UK
      • London, UK, United Kingdom, SW15 4JD
        • University of Roehampton, School of Life and Health Sciences

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

Healthy Male

  • Aged 18-65 years

  • Self-identify as one of the following ethnic groups:

    • Black African/Caribbean
    • South Asian
    • White European

Description

Inclusion Criteria:

  • Male
  • Aged 18-65 years
  • Self-identify as one of the following ethnic groups:

Black African/Caribbean South Asian White European

  • Self-reported ancestry from the same ethnic background for at least three generations
  • Body Mass Index (BMI) ≥25 kg/m² and ≤40 kg/m²
  • Overweight or obese but otherwise generally healthy
  • Generally healthy, with no serious long-term medical conditions or taking medications that may alter body fat distribution
  • Residing in the United Kingdom
  • Able to understand written and spoken English
  • Able and willing to provide written informed consent

  • Willing and able to comply with all study procedures, including:

    • Screening assessments
    • Oral Glucose Tolerance Test (OGTT)
    • Blood sampling
    • Magnetic Resonance Imaging (MRI)

Exclusion Criteria:

  • Previous diagnosis of type 1 diabetes mellitus or type 2 diabetes mellitus
  • HbA1c values within the diabetic range at screening
  • Body Mass Index (BMI) <25 kg/m²

  • Presence of chronic medical conditions known to affect:

    • glucose metabolism
    • insulin sensitivity
    • adipose tissue distribution
    • inflammatory or metabolic status
  • History of cardiovascular, hepatic, renal, endocrine, or metabolic disease that may interfere with study outcomes or participant safety

  • Current use of medications known to influence:

    • glucose metabolism
    • insulin sensitivity
    • lipid metabolism
    • body composition
  • Current use of corticosteroids or other medications affecting metabolic function
  • history of substance or alcohol misuse

  • Contraindications to MRI, including:

    • metallic implants
    • pacemakers
    • severe claustrophobia
  • Inability to undergo venepuncture or cannulation procedures safely
  • Participation in another clinical or interventional research study within the previous 3 months
  • Inability or unwillingness to comply with study procedures or provide informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Black African/Caribbean
Healthy males Black African/Caribbean
Other: Differences in Adipose tissue dysfunction and its contribution to T2DM - Black African/Caribbean
to investigate ethnic differences in adipose tissue dysfunction and its contribution to the development of type 2 diabetes mellitus in overweight and obese men from different ethnic backgrounds
South Asian
Healthy males South Asian
Other: Differences in Adipose tissue dysfunction and its contribution to T2DM -South Asian
to investigate ethnic differences in adipose tissue dysfunction and its contribution to the development of type 2 diabetes mellitus in overweight and obese men from different ethnic backgrounds
White European
Healthy males White European
Other: Differences in Adipose tissue dysfunction and its contribution to T2DM -White European
to investigate ethnic differences in adipose tissue dysfunction and its contribution to the development of type 2 diabetes mellitus in overweight and obese men from different ethnic backgrounds

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
To investigate ethnic differences in glucose metabolism
Time Frame: Baseline and after 2 hours and 10 minutes
Dynamic glucose and insulin responses during Oral Glucose Tolerance Testing (OGTT) in mmol/L
Baseline and after 2 hours and 10 minutes
To investigate ethnic differences adipose tissue dysfunction
Time Frame: Baseline
Regional adipose tissue distribution assessed by MRI. MRI scans will be used to measure the volume and distribution of adipose tissue in specific regions, including visceral adipose tissue (fat surrounding internal organs), subcutaneous adipose tissue (fat beneath the skin), and ectopic fat accumulation in organs such as the liver and pancreas.
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
To investigate ethnic differences in adipokines
Time Frame: Baseline
Changes in Adipokine concentrations (adiponectin, leptin, resistin) expressed in mmol/L
Baseline
To investigate ethnic differences in inflammatory biomarkers
Time Frame: Baseline
Changes in Inflammatory biomarkers (TNF-α, IL-6, IL-8, IL-10, IFN-γ, MCP-1, CRP) in ng/L
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Roehampton

Investigators

  • Study Director: ADELE COSTABILE, University of Roehampton

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 10, 2025

Primary Completion (Actual)

May 12, 2026

Study Completion (Actual)

May 15, 2026

Study Registration Dates

First Submitted

May 26, 2026

First Submitted That Met QC Criteria

June 18, 2026

First Posted (Actual)

June 24, 2026

Study Record Updates

Last Update Posted (Actual)

June 30, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • LSC 24/399

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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