Type 2 Diabetes Prevalence in Asian Americans

Abstract

OBJECTIVE—Asians are thought to be at high risk for diabetes, yet there is little population-based information about diabetes in Asian Americans. The purpose of this study was to directly compare the prevalence of type 2 diabetes in Asian Americans with other racial and ethnic groups in the U.S. using data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). RESEARCH DESIGN AND METHODS—The BRFSS is a population-based telephone survey of the health status and health behaviors of Americans in all 50 states, Guam, Puerto Rico, and the U.S. Virgin Islands. Subjects included 3,071 Asians, 12,561 blacks, 12,153 Hispanics, 2,299 Native Americans, 626 Pacific Islanders, and 129,116 non-Hispanic whites aged ≥30 years. Subjects who reported a physician-diagnosis of diabetes were considered to have type 2 diabetes unless they were diagnosed before age 30. RESULTS—Compared with whites, odds ratios (95% CIs) for diabetes, adjusted for age and sex, were 1.0 (0.7–1.4) for Asians, 2.3 (2.1–2.6) for blacks, 2.0 (1.8–2.3) for Hispanics, 2.2 (1.6–2.9) for Native Americans, and 3.1 (1.4–6.8) for Pacific Islanders. Results adjusted for BMI, age, and sex were 1.6 (1.2–2.3) for Asians, 1.9 (1.7–2.2) for blacks, 1.9 (1.6–2.1) for Hispanics, 1.8 (1.3–2.5) for Native Americans, and 3.0 (1.4–6.7) for Pacific Islanders. CONCLUSIONS—Similar proportions of Asian and non-Hispanic white Americans report having diabetes, but after accounting for the lower BMI of Asians, the adjusted prevalence of diabetes is 60% higher in Asian Americans.

Visceral adiposity, not abdominal subcutaneous fat area, is associated with high blood pressure in Japanese men: the Ohtori study

“…Asians and Asian Americans have been reported to have a lower prevalence of obesity by body mass index compared with Caucasians or African Americans but have greater visceral adiposity at the same body mass index or waist circumference level as Caucasians or African Americans. [19][20][21]32,33 In this study, ASFA was not associated with an increased odds of the prevalence of hypertension in the models that included both IAFA and insulin resistance. This finding was consistent with previous reports in Japanese Americans.…”

“…Differences in ethnicity or adjustment for other potentially confounding variables such as insulin resistance or abdominal subcutaneous fat may explain in part these inconclusive findings. The effect of visceral adiposity on hypertension for Asian populations might be more important than for the other ethnic population because Asians and Asian Americans have been reported to have a lower prevalence of obesity by body mass index compared with Caucasians 19,20 but a greater degree of visceral adiposity. 21 Therefore, we cross-sectionally examined whether visceral adiposity measured by CT was associated with an increased odds of the prevalence of hypertension and of high normal blood pressure or hypertension in Japanese men independent of other adipose depots and insulin resistance.…”

FOXO3A genotype is strongly associated with human longevity

“…Why Type 2 diabetes tends to be more prevalent in Japanese at a relatively low BMI is not completely understood (50). However, there may be metabolic differences in Japanese (and some other Asians) with higher visceral fat in Asians at lower BMI than in whites and blacks (51,52). Indeed, Japan national guidelines reflect such population differences and consider Japanese obese at a BMI of 25 (53).…”

Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft–Gault equation in screening for impaired kidney function in Japanese Americans

“…We also believe our findings may apply to other populations of Asian decent. These populations, like Japanese Americans [3,5], are at increased risk for the development of hypertension [5], diabetes [26] and renal failure [7].…”