Insulin Hypersecretion and Increased Ectopic Fat in South Asian American Adolescents and Young Adults Compared With White and African American Peers: The CHARISMA Study
Authors' conclusion
Compared with White and African American AYAs, South Asian AYAs have higher visceral and liver fat. These findings, along with lower Si and dynamic DI, suggest elevated metabolic risk in South Asian individuals, even at young ages. Higher total and static phase insulin secretion in South Asian AYAs may precede insulin deficiency, reported in adults.
Study context
- Population
- And young adults (AYAs) aged 12–21 years with BMI ≥23 kg/m² or ≥80 percentile, of similar sex, pubertal stage and BMI-Z
- Participants
- 53 / 53 / 49
- Exposure
- South Asian vs White vs African American AYAs
- South Asiann = 53
- Whiten = 53
- African Americann = 49
- Outcome
- Ectopic fat
Methodological detailsMRI/MRS for fat; OGTT with minimal modeling (sensitivity (Si), AUC-ISR, disposition index (DI)); DXA; glucose-potentiated arginine stimulation test
- MRI/MRS for fat; OGTT with minimal modeling (Si, AUC-ISR, DI); DXA; glucose-potentiated arginine stimulation test
Main finding
As reported in the abstract
- South Asian vs White: P < 0.001 vs. White
- South Asian vs African American: P = 0.009 vs. African American
- South Asian vs White, African American: P < 0.001 vs. both
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Insulin sensitivity, secretion and DISouth Asian vs White · Lower Si with South Asian | P = 0.006 |
| Insulin sensitivity, secretion and DISouth Asian vs White · Higher dynamic AUC-ISR with South Asian | P = 0.003 |
| Insulin sensitivity, secretion and DISouth Asian vs White, African American · Higher total and static AUC-ISR with South Asian | P < 0.001 |
| Insulin sensitivity, secretion and DISouth Asian vs African American · Lower dynamic DI with South Asian | P = 0.039 |
| Insulin clearanceSouth Asian vs White · Lower with South Asian | P = 0.027 |
| Insulin clearanceSouth Asian vs African American · Lower with South Asian | P = 0.007 |
| First-pass hepatic insulin extractionAfrican American vs South Asian · Lower with African American | P < 0.0001 |
| First-pass hepatic insulin extractionAfrican American vs White · Lower with African American | P = 0.027 |
Insulin sensitivity, secretion and DI
- Differences in Si, dynamic AUC-ISR and dynamic DI lost significance after adjustment for visceral or liver fat; higher total and static AUC-ISR in South Asian AYAs persisted
Original publication
Insulin Hypersecretion and Increased Ectopic Fat in South Asian American Adolescents and Young Adults Compared With White and African American Peers: The CHARISMA Study. Diabetes Care. Published 20 April 2026. doi:10.
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