Determination of membrane lipid differences in insulin resistant diabetes mellitus type 2 in whites and blacks

Insulin resistance in diabetes mellitus type 2 (DM2) can result from membrane lipid alterations. Blacks are at a higher risk of developing DM2; therefore, we investigated whether membrane lipid differences exist between blacks and whites and if differences contribute to impaired insulin binding in diabetes.

Subjects were recruited from four groups: white control (n = 10), black control (n = 10), white diabetic (n = 5), and black diabetic (n = 10). Diabetic subjects who had DM2 with insulin resistance on insulin monotherapy were matched by age and sex. The following determinations were made: fasting serum glucose, fasting serum insulin, plasma lipid profile, red blood cell (RBC) membrane lipids and cholesterol, and RBC insulin binding.

The membrane lipid analysis showed racial differences in phosphatidyl ethanolamine (PE) and phosphatidyl choline (PC). The plasma membrane of whites showed higher PE and lower PC levels than that in blacks. The RBC rheologic (PE/phosphatidyl serine) properties (deformability) were lower in diabetics and black subjects. The saturated nature of RBC ([sphingomyelin + PC)/(PE + phosphatidyl serine]) was the lowest in white control subjects (P < 0.056).

The combination of increased saturated/polyunsaturated fatty acids, increased saturated nature, and increased cholesterol/phospholipid can contribute to decreased membrane fluidity, resulting in insulin resistance. Also, decreased RBC deformability can make oxygen delivery through the capillaries difficult, create tissue hypoxia, and contribute to some of the known complications of diabetes. Membrane lipid alteration may be one of the reasons for a higher incidence of diabetes among blacks.