December 1, 2009

Diabetes Prevalence and Body Mass Index Differ by Ethnicity: The Multiethnic Cohort

Gertraud Maskarinec, M.D., Ph.D., Andrew Grandinetti, Ph.D., Grace Matsuura, M.P.H., Sangita Sharma, Ph.D., Marjorie Mau, M.D., Brian E. Henderson, M.D., and Laurence N. Kolonel, M.D., Ph.D.

Ethnicity & Disease

Objective—The high prevalence of diabetes in non-Caucasian populations is reported not only for Native Hawaiians who suffer from high rates of obesity, but also for Japanese with a relatively low body weight. The objectives of this study were to estimate the prevalence of diabetes among participants of the Multiethnic Cohort (MEC) and to examine the association of body mass index (BMI) with self-reported diabetes by ethnicity.

Design—Cross-sectional analysis of baseline questionnaire at cohort entry.

Participants—187,439 MEC subjects in Hawaii and California from five ethnic groups.

Main outcome measures—Participants completed a 26-page, self-administered survey with questions concerning anthropometrics, demographic, medical, lifestyle, and food consumption behavior.  Age-adjusted prevalence of diabetes was calculated by sex and ethnicity and stratified by BMI. Prevalence ratios were determined using logistic regression while adjusting for variables that are known to be related to diabetes. The c statistic was computed to compare models with different confounders.

Results—The prevalence of self-reported diabetes in the MEC was 11.6%. The age-adjusted diabetes prevalence ranged from 6.3% in Caucasians to 10.2% in Japanese, 16.1% in Native Hawaiians, 15.0% in African-Americans, and 15.8% in Latinos. After adjustment for known risk factors, the prevalence ratio by ethnicity ranged between 2.1 (African-American and Latino), 2.8 (Japanese), and 3.0 (Native Hawaiian) as compared to Caucasians. These differences were observed among all BMI categories.

Conclusions—Ethnic differences in the prevalence of diabetes persisted after stratification by BMI. The prevalence of diabetes was at least two-fold higher in all ethnic groups than among Caucasians.

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