Elena Flowers1,2, Feng Lin3, Namratha R Kandula4, Matthew Allison5, Jeffrey J Carr6, Jingzhong Ding7, Ravi Shah8, Kiang Liu9, David Herrington10, Alka M Kanaya3,11. 1. Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA elena.flowers@ucsf.edu. 2. Institute for Human Genetics, University of California, San Francisco, San Francisco, CA. 3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA. 4. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 5. Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA. 6. Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN. 7. Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC. 8. Division of Cardiology, Massachusetts General Hospital, Boston, MA. 9. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 10. Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University, Winston-Salem, NC. 11. Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA.
Abstract
OBJECTIVE: South Asians have a higher prevalence of type 2 diabetes compared with other race/ethnic groups. Body composition is associated with the risk for type 2 diabetes. Differences in body composition between South Asians and other race/ethnic groups are one hypothesized mechanism to explain the disproportionate prevalence of type 2 diabetes in this population. RESEARCH DESIGN AND METHODS: This study used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohorts to determine whether body composition mediated the elevated prevalence of impaired fasting glucose and type 2 diabetes in South Asians. Participants (n = 2,615) with complete body composition data were included. Ordinal logistic regression models were calculated to determine the odds for glycemic impairment in South Asians compared with the MESA cohort. RESULTS: In multivariate models, South Asians had a significantly higher prevalence of glycemic impairment and type 2 diabetes compared with all four race/ethnic groups included in the MESA (P < 0.001 for all). In unadjusted and multivariate adjusted models, South Asians had higher odds for impaired fasting glucose and type 2 diabetes compared with all other race/ethnic groups (P < 0.001 for all). The addition of body composition measures did not significantly mitigate this relationship. CONCLUSIONS: We did not identify strong evidence that accounting for body composition explains differences in the risk for type 2 diabetes. Future prospective studies of the MESA and MASALA cohorts are needed to understand how adipose tissue impacts the risk for type 2 diabetes and how to best assess this risk.
OBJECTIVE: South Asians have a higher prevalence of type 2 diabetes compared with other race/ethnic groups. Body composition is associated with the risk for type 2 diabetes. Differences in body composition between South Asians and other race/ethnic groups are one hypothesized mechanism to explain the disproportionate prevalence of type 2 diabetes in this population. RESEARCH DESIGN AND METHODS: This study used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohorts to determine whether body composition mediated the elevated prevalence of impaired fasting glucose and type 2 diabetes in South Asians. Participants (n = 2,615) with complete body composition data were included. Ordinal logistic regression models were calculated to determine the odds for glycemic impairment in South Asians compared with the MESA cohort. RESULTS: In multivariate models, South Asians had a significantly higher prevalence of glycemic impairment and type 2 diabetes compared with all four race/ethnic groups included in the MESA (P < 0.001 for all). In unadjusted and multivariate adjusted models, South Asians had higher odds for impaired fasting glucose and type 2 diabetes compared with all other race/ethnic groups (P < 0.001 for all). The addition of body composition measures did not significantly mitigate this relationship. CONCLUSIONS: We did not identify strong evidence that accounting for body composition explains differences in the risk for type 2 diabetes. Future prospective studies of the MESA and MASALA cohorts are needed to understand how adipose tissue impacts the risk for type 2 diabetes and how to best assess this risk.
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