In a comprehensive research study featured online in December 2018 in Medical Xpress news, lead author Claudia Langenberg, MD, affiliated with the MRC Epidemiology Unit, University of Cambridge, United Kingdom, and colleagues studied genetic associations and underlying influences found in specific genomic regions that affect the regulation of appetite, adipose storage beta-cell activity, and beta-cell failure. The team reports that other studies have already demonstrated the need (and value) for approaching diabetes as a genetic predisposition model versus the current approach, which the authors termed Eurocentric.

The researchers acknowledge that despite the progress that has been made in defining type 2 diabetes as a disease with a “highly polygenic architecture,” they note that current science is limited to a small subtype with limited understanding of genomic involvement, despite the global impact of this disease. While an apple shape has previously been recognized as a higher-risk fat distribution, this study is connecting the shape to the genetic make-up of each individual.

The study team conducted a comprehensive literature search of PubMed with terms including, but not limited to, all diabetes and genome-wide associations, and assessed the distribution of body fat in 18,000 subjects using low-intensity x-ray scans that differentiated fat from bone and muscle. Researchers also studied the genetic profiles of more than 600,000 subjects from several large international studies, discovering over 200 different genetic variations associated with higher abdominal fat versus fat found in the hips.

In a recent interview, Langenberg commented, “We found that both of the genetic variants we identified were associated with higher risk of Type 2 diabetes and heart attacks.” Lead author Dr. Luca Lotta, senior clinical investigator at the MRC Epidemiology Unit, further elaborated that “It may seem counter-intuitive to think that some people with less fat around their hips are at higher risk of diabetes or heart disease. We believe that this is due to a genetically-determined inability to store excess calories safely in the hip region as opposed to elsewhere. This means that individuals with this genetic make-up preferentially store their excess fat in the liver, muscles or pancreas, or in their blood in the form of circulating fats and sugar, any of which can lead to a higher disease risk,” said Lotta.
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