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How does ethnicity affect the association between obesity and diabetes?
Author(s) -
Diaz V. A.,
Mainous A. G.,
Baker R.,
Carnemolla M.,
Majeed A.
Publication year - 2007
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2007.02244.x
Subject(s) - medicine , body mass index , waist , ethnic group , diabetes mellitus , anthropometry , obesity , waist–hip ratio , health survey for england , national health and nutrition examination survey , demography , cross sectional study , receiver operating characteristic , waist to height ratio , gerontology , environmental health , endocrinology , population , pathology , sociology , anthropology
Aims To examine the utility of body mass index (BMI), waist circumference (WC) and waist‐to‐height ratio (WHR) in assessing diabetes risk across different ethnic groups. Methods Cross‐sectional analysis of data for eight ethnic groups from the 2003–2004 National Health and Nutrition Examination Survey and 2003–2004 Health Survey for England was performed. In 11 624 adults ≥ 20 years old, self‐reported as US White, US Black, Mexican American, English White, English Black, Bangladeshi, Pakistani, Indian or Chinese the presence of diabetes, defined as self‐report of doctor diagnosis or glycated haemoglobin (HbA 1c ) > 6.1%, was ascertained. Comparisons of proportions were made using χ 2 ‐tests. Receiver operating characteristic (ROC) curves were calculated for BMI, WC and WHR predicting diabetes. Results Other ethnic groups had a higher prevalence of diagnosed diabetes than English Whites. The crude prevalence of diabetes in English Whites of normal weight (BMI < 25 kg/m 2 ) was 3.4%. Higher prevalences were seen in other ethnic groups (5.0–10.9%). Based on ROC curves, both WC and WHR had better discriminating ability for diabetes than BMI for both genders and some ethnic groups. Conclusions Ethnic differences exist in the crude prevalence of diabetes, even in those characterized as normal weight by BMI. Thus, clinicians need to exercise caution in interpreting diabetes risk associated with a normal BMI. The use of other anthropometric measures, such as WC or WHR, may improve risk determination across different ethnic groups. More research is needed to determine the thresholds for different anthropometric measures that improve diabetes risk determination.