{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T19:02:14Z","timestamp":1767985334978,"version":"3.49.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T00:00:00Z","timestamp":1691020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008897","name":"Janssen Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001352","name":"National University of Singapore","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The impact of obesity on the risk for type 2 diabetes differs between males and females; however, the underlying reasons are unclear. This study aimed to investigate the effect of sex on obesity\u2010driven changes in the mechanisms regulating glucose metabolism (insulin sensitivity and secretion) among Asian individuals without diabetes in Singapore.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study assessed glucose tolerance using oral glucose tolerance test, insulin\u2010mediated glucose uptake using hyperinsulinemic\u2010euglycemic clamp, acute insulin response using an intravenous glucose challenge, and insulin secretion rates in the fasting state and in response to glucose ingestion using mathematical modeling in 727 males and 952 females who had normal body weight (<jats:italic>n<\/jats:italic>\u2009=\u2009602, BMI\u2009&lt;\u200923\u2009kg\/m<jats:sup>2<\/jats:sup>), overweight (<jats:italic>n<\/jats:italic>\u2009=\u2009662, 23\u2009\u2264\u2009BMI\u2009&lt;\u200927.5), or obesity (<jats:italic>n<\/jats:italic>\u2009=\u2009415, BMI\u2009\u2265\u200927.5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no sex differences among lean individuals. Obesity gradually worsened metabolic function, and the progressive adverse effects of obesity on insulin action and secretion were more pronounced in males than females, such that among participants with obesity, females had greater insulin sensitivity, lower insulin secretion, and lower fasting insulin concentration than males. The increase in waist to hip ratio with increasing BMI was more pronounced in males than females.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The female sex exerts a protective effect on obesity\u2010driven dysregulation of glucose metabolism in Asian individuals without diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.23833","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T09:28:59Z","timestamp":1691054939000},"page":"2304-2314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Asian females without diabetes are protected from obesity\u2010related dysregulation of glucose metabolism compared with males"],"prefix":"10.1002","volume":"31","author":[{"given":"Michelle H.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eveline","family":"Febriana","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maybritte","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"},{"name":"Department of Medicine National University Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Baig","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey B.","family":"Halter","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"},{"name":"Division of Geriatric and Palliative Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faidon","family":"Magkos","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Exercise and Sports University of Copenhagen  K\u00f8benhavn Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1570-4417","authenticated-orcid":false,"given":"Sue\u2010Anne","family":"Toh","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore  Singapore"},{"name":"Department of Medicine National University Hospital  Singapore"},{"name":"NOVI Health  Singapore"},{"name":"Regional Health System Office National University Health System  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,3]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Diabetes in America","author":"Ley SH","year":"2018"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118387658.ch3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.224"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00063.2017"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nm.4350"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05245-x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2013.00037"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0243-x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0442"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.726"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00088-7"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2018-01421"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2009.10.013"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2009.03.001"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-2061"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05040-3"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2014.86"},{"key":"e_1_2_12_19_1","unstructured":"International Diabetes Federation.IDF Diabetes Atlas.9th ed. 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