Quantifying the Sex‐Race/Ethnicity‐Specific Burden of Obesity on Incident Diabetes Mellitus in the United States, 2001 to 2016: MESA and NHANES

Abstract

Background Given the increasing prevalence of diabetes mellitus (DM) in the United States, estimating the effects of population‐level increases in obesity on incident DM has substantial implications for public health policy. Therefore, we determined the population attributable fraction, which accounts for the prevalence and excess risk of DM associated with obesity. Methods and Results We included non‐Hispanic White, non‐Hispanic Black, and Mexican American participants without DM at baseline from MESA (Multi‐Ethnic Study of Atherosclerosis) with available data on body mass index and key covariates from 2000 to 2017 to calculate unadjusted and adjusted (age, study site, physical activity, diet, income, and education level) hazard ratios (HR) for obesity‐attributable DM. We calculated national age‐adjusted prevalence estimates for obesity using data from NHANES (National Health and Nutrition Examination Survey) in 4 pooled cycles (2001–2016) among adults with similar characteristics to MESA participants. Last, we calculated unadjusted and adjusted population attributable fractions from the race/ethnic and sex‐specific HR and prevalence estimates. Of 4200 MESA participants, the median age was 61 years, 46.8% were men, 53.9% were non‐Hispanic White, 32.9% were non‐Hispanic Black, and 13.3% were Mexican. Among MESA participants, incident DM occurred in 11.6% over a median follow‐up of 9.2 years. The adjusted HR for obesity‐related DM was 2.7 (95% CI, 2.2–3.3). Adjusted population attributable fractions were 0.35 (95% CI, 0.29–0.40) in 2001 to 2004 and 0.41 (95% CI, 0.36–0.46) in 2013 to 2016, and greatest among non‐Hispanic White women. Conclusions The contribution of obesity towards DM in the population remains substantial and varies significantly by race/ethnicity and sex, highlighting the need for tailored public health interventions to reduce obesity. Registration URL: https://www.clinicaltrials.gov ; Unique identifiers: NC00005487, NCT00005154.

Pasos Hacia La Salud II: study protocol for a randomized controlled trial of a theory- and technology-enhanced physical activity intervention for Latina women, compared to the original intervention

“…Given the high rates of inactivity and related co-morbidities among Latina women [3,4,6], this is a priority population for PA promotion. Efficacious and cost-effective PA interventions for Latina women are urgently needed to address this public health concern and advance health equity.…”

“…Almost two-thirds of Latinas are insufficiently active [1], putting them at increased risk for many chronic diseases. Furthermore, Latinos are the largest ethnic minority group in the USA [2] and experience disproportionally high rates of many chronic diseases such as obesity and diabetes [3,4]. Despite the benefits of physical activity (PA) for enhancing health, reducing illness, disability, and early death, Latinas are one of the least active populations in the USA.…”

Evaluation of anthropometric indices as a predictor of diabetes in Dong and Miao ethnicities in China: A cross-sectional analysis of China Multi-Ethnic Cohort Study

“…After our stratification, the number of people in each group was reduced, especially in men, which may have led to the fact that obesity indicators did not show good predictive power in men because of the small sample size. In addition, obesity contributes significantly to diabetes, however, this differs significantly by race/ethnicity and gender [18]. As known, women have higher body fat than men.…”

“…Only one study in China showed that Tibetans had a significantly lower prevalence of diabetes than Han Chinese, and little information was available about other ethnic groups [17]. It is well known that obesity contributes significantly to diabetes, however, this differs significantly by race/ethnicity and gender [18].…”

From biobanking to personalized prevention of obesity, diabetes and metabolic syndrome

“…ВНП -варианты нуклеотидных последовательностей, ДИ -доверительный интервал, ИМТ -индекс массы тела, МС -метаболический синдром, НАЖБП -неалкогольная жировая болезнь печени, ОРотношение рисков, СД -сахарный диабет, СД2 -СД 2 типа, СТБ -соотношение окружности талии и бедер, СТБ ИМТ -СТБ с поправкой на ИМТ, ФР -факторы риска, ШГР -шкала генетического риска, AUC -Area Under Curve (площадь под кривой), GWAS -genomewide association study (полногеномный поиск ассоциаций), HbA 1c -гликированный гемоглобин, MODY -Maturity Onset Diabetes of the Young (cахарный диабет взрослого типа у молодых и NHANES (National Health And Nutrition Examination Survey) до 41% новых случаев СД-2 обусловлены ожирением, что говорит о тесной этиологической и патогенетической связи этих заболеваний [3]. Совокупность метаболических нарушений, включающая инсулинорезистентность, ожирение, повышение уровня триглицеридов в крови, снижение уровня холестерина липопротеинов высокой плотности, в сочетании с повышенным уровнем артериального давления объединяются в понятие метаболического синдрома (МС) [4].…”