Non-autoimmune diabetes in young people from Assam, India: the PHENOEINDY-2 study
Authors' conclusion
Diabetes in the young people of this impoverished population is heterogeneous, but the majority of patients are not overweight/obese or insulin-resistant. Overall, these participants conform to the thin-fat phenotype, and their diabetes is predominantly driven by beta cell deficiency. The sociodemographic history and physical characteristics of this population suggest a role for multigenerational undernutrition in the aetiology of non-autoimmune diabetes in these young patients from Assam.
Study context
- Population
- Young patients clinically diagnosed with T2D at <40 years attending the outpatient department of Assam Medical College and Hospital, Dibrugarh (North-East India); mostly tea garden workers
- Participants
- 240 vs 252
- Exposure
- GADA-negative young patients with diabetes vs control participants with normal glucose tolerance
- Patients with diabetesn = 240
- Controln = 252reference
- Outcome
- Phenotype of patients with diabetes
Methodological detailscase-control comparison, comparison with NHANES non-Hispanic white Americans
- Case-control comparison
- Comparison with NHANES non-Hispanic white Americans
Main finding
As reported in the abstract
- Stunted growth (male <161.2 cm, female <149.8 cm)
- 28%
- Anaemic
- 27%
- Lean (BMI <25 kg/m²)
- 68%
- Underweight (BMI <18.5 kg/m²)
- 14%
- Overweight/obese (BMI ≥25 kg/m²)
- 32%
- Median HOMA-B (severely beta cell-deficient)
- 25.7
- Median HOMA-S (moderately insulin-resistant)
- 103
Observational data: associations, not effects.
Further findings
Adiposity by DXA (body fat >25% in males or >35% in females)
Comparison with non-Hispanic white Americans (NHANES)
- Assamese controls and patients had higher WHR, body roundness index, and total and truncal adiposity across the range of BMI ('thin-fat' phenotype)
Lipids
- Patients had higher triacylglycerol and lower HDL-cholesterol concentrations than controls
Underweight patients (<18.5 kg/m²)
- Most hyperglycaemic (FPG and HbA1c); severely beta cell-deficient but insulin-sensitive
Original publication
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