Ethnicity and sex are strong determinants of diabetes in an urban Western society: implications for prevention

Abstract

Aims/hypothesis: This study was conducted to investigate the prevalence of diabetes and its association with ethnicity and sex, to identify subgroups at special risk. Methods:We performed a population-based cross-sectional survey of 30-to 67-year-olds in an area of Oslo with low socio-economic status, and collected data using questionnaires, physical examinations and serum analyses for the 2,513 participants (attendance rate 49.3%). Results: In the age group 30-59 years, mean BMI was 28.5 (95% CI: 27.5-29.6) for South Asian women, 26.1 (25.9-26.4) for Western women, 26.7 (26.1-27.4) for South Asian men and 27.2 (26.9-27.5) for Western men. The diabetes prevalence rates were 27.5% (18.1-36.9) for South Asian women, 2.9% (1.9-3.4) for Western women, 14.3% (8.0-20.7) for South Asian men and 5.9% (4.2-7.5) for Western men. The age-adjusted odds ratio (OR) for diabetes for women vs men was 1.9 (0.9-4.1) for South Asians, and 0.4 (0.3-0.6) for the Western population (p<0.001). The ageadjusted OR for diabetes for South Asians vs Westerners was 11.0 (5.8-21.1) for women and 3.0 (1.6-5.4) for men, and after adjustment for WHR the ORs were 7.7 (3.9-15.3) for women and 2.6 (1.4-4.9) for men. After additional adjustments for physical activity, education, body height and fertility for women, the OR was 6.0 (2.3-15.4) for women and 1.9 (0.9-4.0) for men. Conclusions/interpretation: The alarmingly high prevalence of diabetes among South Asian women in Norway needs further investigation, as it has considerable public health implications. Ethnic differences in OR for diabetes persisted after adjustment for age, adiposity, physical activity and education. These differences were still present for women after additional adjustment for body height and fertility.

The STORK Groruddalen research programme: A population-based cohort study of gestational diabetes, physical activity, and obesity in pregnancy in a multiethnic population. Rationale, methods, study population, and participation rates

“…An alarmingly high prevalence of diabetes, especially in South Asian women (27.5% versus 2.9% in Norwegians), was found in this area [16] and the majority of middle-aged non-Western women were physically inactive and obese. Perinatal mortality is doubled in offspring of non-Western women compared to Norwegians [17].…”

Type 2 diabetes and cardiovascular risk in the UK south Asian community

“…These are not strictly comparable because of varying methodology and differing diagnostic criteria. Irrespective of the countries immigrant south Asian populations have settled in and of regional, cultural and religious differences, however, there is strong evidence, gathered over the past half-century, that the prevalence of type 2 diabetes is increased among these individuals compared with indigenous populations [2][3][4][5][6] (Fig. 1).…”

Low level of objectively measured physical activity and cardiorespiratory fitness, and high prevalence of metabolic syndrome among Pakistani male immigrants in Oslo, Norway

“…In particular, people from south Asia seem to have a high risk (2)(3)(4)(5). Results from the "Romsås in motion" project in Oslo demonstrated a higher prevalence of self reported T2D among people from south Asia compared to ethnic Norwegians (6). The reason for this high prevalence of T2D is not known, but might be partly explained by susceptibility towards developing insulin resistance (7,8).…”