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Lower obesity cutoffs for ethnic groups could improve diabetes intervention
Differences in diabetes prevalence by ethnicity, along with the disease’s varying associations with adiposity, suggest obesity should be defined at lower thresholds in nonwhite populations to optimize treatment, according to research published in Diabetes Care.
In the Asian population, it may be beneficial to adopt a substantially lower threshold for obesity for South Asian groups compared with Chinese groups, researchers in the United Kingdom contend.
“Using current guidelines to target interventions at individuals with obesity would result in a higher risk threshold for diabetes being applied to nonwhite individuals,” the researchers wrote.
Through the UK Biobank, Uduakobong E. Ntuk, MPH, a PhD student at the Institute of Health and Wellbeing, University of Glasgow, and colleagues recruited at 502,682 residents aged 40 to 69 years from the country’s four largest ethnic subgroups. The investigators used baseline data from 471,174 (96.1%) white participants, 9,631 (2%) South Asian, 7,949 (1.6%) black and 1,534 (0.3%) Chinese.
Regression models were created to determine associations between anthropometric measures (BMI, waist circumference, percentage body fat and waist-to-hip ratio) and diabetes prevalence, with data stratified by sex. Adjustments were made for age, physical activity, socioeconomic status and heart disease.
The likelihood of having diabetes was two to four times higher in non-whites. Based on diabetes prevalence in white participants with BMI=30, equivalent BMI measurements were lower in South Asians (BMI=22), blacks (BMI=26), Chinese women (BMI=24) and Chinese men (BMI=26).
Based on waist circumferences of 88 cm in white women and 102 cm in white men, equivalent measurements were, respectively, 70 cm and 79 cm in South Asians, 79 cm and 88 cm in blacks and 74 cm and 88 cm in Chinese.
“Lower obesity thresholds should be applied to nonwhite groups, and should be specific to each ethnic group, in order to ensure an equitable approach based on equivalent risk,” the researchers wrote. “In particular, the present data show that Asians should not be treated as a single group when considering obesity thresholds, an approach that has been adopted in some previous recommendations, with South Asians requiring substantially lower obesity cutoff than Chinese. Moreover, these findings, which will aid future guidelines in this area, could help to promote better public education and health measures to attenuate obesity risks in high-risk ethnic populations,” the researchers wrote.
Disclosures: The research was conducted using the UK Biobank resource, established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency, with funding from the Welsh Assembly Government and the British Heart Foundation. One researcher was funded by the Niger Delta Development Commission, Nigeria.