title: Ethnicity modifies the relationships of insulin resistance, inflammation, and adiponectin with obesity in a multiethnic Asian population.
abstract: OBJECTIVE
  The development of obesity-related metabolic disorders varies with ethnicity. We examined whether ethnicity modifies the relationship between BMI and three metabolic pathways (insulin resistance, inflammation, and adiponectin) that are involved in the pathogenesis of diabetes and cardiovascular disease (CVD).
  
  
  METHODS
  We analyzed data from 4,804 Chinese, Malay, and Asian-Indian residents of Singapore with complete data on insulin resistance (IR), C-reactive protein (CRP), and total adiponectin levels. Linear regression models with an interaction term ethnicity*BMI were used to evaluate whether ethnicity modifies the association between BMI and IR, CRP, and adiponectin.
  
  
  RESULTS
  In both uni- and multivariate analyses, BMI was directly associated with IR and CRP and inversely with adiponectin across all ethnic groups. When compared with Chinese and Malays, Asian-Indians had higher IR and CRP and lower adiponectin levels. The associations between BMI and its metabolic pathways were significantly stronger in Chinese than in other ethnic groups. The increase in IR and CRP and the decrease in adiponectin for each unit increase in BMI were greater in Chinese than in other ethnic groups. The findings were similar when waist circumference was used in the analyses instead of BMI.
  
  
  CONCLUSIONS
  The impact of BMI on IR, CRP, and adiponectin appears greater in Chinese as compared with other major Asian ethnic groups. This may partly explain the rapid increase in the prevalence of diabetes and CVD in Chinese populations and highlights the importance of weight management in Asian ethnic groups despite the apparently low levels of obesity.
authors.affiliation: Department of Medicine, National University Health System, Singapore, Singapore.
authors.forename: Chin Meng
authors.initials: CM
authors.lastname: Khoo
authors.forename: Sarina
authors.initials: S
authors.lastname: Sairazi
authors.forename: Siska
authors.initials: S
authors.lastname: Taslim
authors.forename: Daphne
authors.initials: D
authors.lastname: Gardner
authors.forename: Yi
authors.initials: Y
authors.lastname: Wu
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
authors.forename: E
authors.initials: E
authors.lastname: Shyong Tai
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D044466:Asian People; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D052242:Adiponectin; D002097:C-Reactive Protein