Metabolic inflexibility in substrate use is present in African-American but not Caucasian healthy, premenopausal, nondiabetic women

Abstract

Context: There is an increased prevalence of obesity and insulin resistance in African-American compared with Caucasian females. Metabolic inflexibility (MI) is the inability to switch the use of lipids and carbohydrates in the peripheral tissue (i.e. muscle) based upon substrate availability.

Objective: We examined whether MI exists in African-American females. MAIN OUTCOME MEASURES AND DESIGN: We measured substrate use differences during eucaloric, macronutrient-manipulated diets [high fat (50% fat, 35% carbohydrate, 15% protein) vs. low fat (30% fat, 55% carbohydrate, 15% protein)] between Caucasian and African-American women. We also compared differences in substrate use in response to insulin infusion during two-step pancreatic-euglycemic clamps and epinephrine infusion during lipolysis studies. In each study, similar groups of Caucasian and African-American women were compared.

Results: Caucasians had significantly higher fat oxidation (FO) (P = 0.01) and lower carbohydrate oxidation (P < 0.01) during the high-fat vs. low-fat diet, whereas no significant differences were observed in African-Americans. The African-American women also failed to significantly suppress FO during the second step of the pancreatic-euglycemic clamp despite a doubling of their fasting plasma insulin and failed to increase their FO or decrease their carbohydrate oxidation in response to epinephrine infusion as much as Caucasian women did. The response of free fatty acid turnover rates to insulin and epinephrine stimulation was similar between races.

Conclusion: The impaired substrate use observed in African-American women during these three studies demonstrates the existence of MI and may contribute to their greater prevalence of obesity and insulin resistance.

Figures

Fig. 1

A, FO rates; B, CO rates; C, NPRQ in Caucasian (○) and African-American (●) women during HF and LF diets. A, The diet by race interaction was P < 0.01 and the change within Caucasian women was P < 0.01 and within African-American women was P = 0.86 (LF vs. HF); B, the diet by race interaction was P < 0.01 and the change within Caucasian women was P < 0.01 and within African-American women was P = 0.69; C, the diet by race interaction was P = 0.10 and the change within Caucasian women was P < 0.01 and within African-American women was P = 0.42.

Fig. 2

A, FO rates; B, CO rates; C, NPRQ in Caucasian (○) and African-American (●) women during pancreatic euglycemic clamp. A, The overall time point by race interaction was P = 0.40, and the overall race effect was P = 0.02; B, the overall time point by race interaction was P = 0.05; C, the overall time point by race interaction was P = 0.25, and the overall race effect was P = 0.01.

Fig. 3

A, FO rates; B, CO rates; C, NPRQ in Caucasian (○) and African-American (●) women during an epinephrine-induced lipolysis study. A, The time point by race interaction was P = 0.30, and the change within Caucasian women was P < 0.01 and within African-American women was P = 0.07; B, the time point by race interaction was P = 0.01, and the change within Caucasian women was P < 0.01 and within African-American was P = 0.20; C, the time point by race interaction was P = 0.06 and the change within Caucasian was P < 0.01 and within African-American women was P = 0.53.