{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:59:27Z","timestamp":1791068367453,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T00:00:00Z","timestamp":1346889600000},"content-version":"vor","delay-in-days":1528,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Subsets of metabolically \u201chealthy obese\u201d and \u201cat\u2010risk\u201d normal\u2010weight individuals have been previously identified. The aim of this study was to explore the determinants of these phenotypes in black South African (SA) women.<\/jats:p><jats:p><jats:bold>Methods and Procedures:<\/jats:bold> From a total of 103 normal\u2010weight (BMI \u2264 25 kg\/m<jats:sup>2<\/jats:sup>) and 122 obese (BMI \u2265 30 kg\/m<jats:sup>2<\/jats:sup>) black SA women, body composition, fat distribution, blood pressure, fasting glucose levels, insulin resistance, and lipid profiles were measured. Questionnaires relating to family history, physical activity energy expenditure (PAEE), and socio\u2010demographic variables were administered. The subjects were classified as insulin sensitive or insulin resistant according to the homeostasis model assessment of insulin resistance (HOMA\u2010IR) (\u22651.95 insulin resistant).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Our study showed that 22% of the normal\u2010weight women were insulin resistant and 38% of the obese women were insulin sensitive. Increased visceral adipose tissue (VAT) (<jats:italic>P<\/jats:italic> = 0.001) and decreased VAT\/leg fat mass (<jats:italic>P<\/jats:italic> \u2264 0.001), independent of total body fatness, distinguished between the phenotypes. Moreover, the insulin\u2010sensitive women were of higher socioeconomic status, did more leisure and vigorous PAEE and were less likely to use injectable contraceptives. Using a regression model, body fat distribution, percent body fat, age, log leisure PAEE, and use of injected contraception accounted for 35% of the variance in HOMA\u2010IR in the normal\u2010weight women. In the obese women, 34% of the variance in HOMA\u2010IR was explained by the same variables, excluding PAEE. No differences in smoking status or family history of metabolic disease were found between the phenotypes.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> Central fat distribution, total adiposity, socioeconomic status, leisure PAEE, and use of injectable contraceptives distinguished between insulin\u2010sensitive and insulin\u2010resistant black SA women.<\/jats:p>","DOI":"10.1038\/oby.2008.233","type":"journal-article","created":{"date-parts":[[2008,4,17]],"date-time":"2008-04-17T17:23:20Z","timestamp":1208453000000},"page":"1602-1609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Determinants of Insulin\u2010resistant Phenotypes in Normal\u2010weight and Obese Black African Women"],"prefix":"10.1002","volume":"16","author":[{"given":"Courtney L.","family":"Jennings","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle V.","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Collins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Joffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi S.","family":"Levitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia H.","family":"Goedecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,6]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"i","article-title":"Report of a WHO consultation on obesity","volume":"894","author":"Obesity: preventing and managing the global epidemic","year":"2000","journal-title":"World Health Organ Tech Rep Ser"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2002.141"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0535"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1262-3636(07)70156-8"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1462-8902.2004.00377.x"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2005.130"},{"key":"e_1_2_7_8_2","first-page":"224","article-title":"Low frequency of adverse sequelae of obesity in South African rural black women","volume":"59","author":"Walker AR","year":"1989","journal-title":"Int J Vitam Nutr Res"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/146642409011000311"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0594"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.3.1020"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI117518"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0165"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.86.7.3296"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijo.0803576"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0482"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0265"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.48.11.2210"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2004.173"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/34.8.1617"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1139\/h06-092"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.19.2486"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.9.2222"},{"key":"e_1_2_7_24_2","first-page":"480","article-title":"Risk factors for coronary heart disease in the black population of the Cape Peninsula. 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