title: Ethnic-specific obesity cutoffs for diabetes risk: cross-sectional study of 490,288 UK biobank participants.
abstract: OBJECTIVE
  To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed in white populations in terms of diabetes prevalence.
  
  
  METHODS
  UK Biobank recruited 502,682 U.K. residents aged 40-69 years. We used baseline data on the 490,288 participants from the four largest ethnic subgroups: 471,174 (96.1%) white, 9,631 (2.0%) South Asian, 7,949 (1.6%) black, and 1,534 (0.3%) Chinese. Regression models were developed for the association between anthropometric measures (BMI, waist circumference, percentage body fat, and waist-to-hip ratio) and prevalent diabetes, stratified by sex and adjusted for age, physical activity, socioeconomic status, and heart disease.
  
  
  RESULTS
  Nonwhite participants were two- to fourfold more likely to have diabetes. For the equivalent prevalence of diabetes at 30 kg/m(2) in white participants, BMI equated to the following: South Asians, 22.0 kg/m(2); black, 26.0 kg/m(2); Chinese women, 24.0 kg/m(2); and Chinese men, 26.0 kg/m(2). Among women, a waist circumference of 88 cm in the white subgroup equated to the following: South Asians, 70 cm; black, 79 cm; and Chinese, 74 cm. Among men, a waist circumference of 102 cm equated to 79, 88, and 88 cm for South Asian, black, and Chinese participants, respectively.
  
  
  CONCLUSIONS
  Obesity should be defined at lower thresholds in nonwhite populations to ensure that interventions are targeted equitably based on equivalent diabetes prevalence. Furthermore, within the Asian population, a substantially lower obesity threshold should be applied to South Asian compared with Chinese groups.
authors: Institute of Health and Wellbeing, University of Glasgow, Glasgow, U.K.
authors: Uduakobong E
authors: UE
authors: Ntuk
authors: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, U.K.
authors: Jason M R
authors: JM
authors: Gill
authors: Institute of Health and Wellbeing, University of Glasgow, Glasgow, U.K.
authors: Daniel F
authors: DF
authors: Mackay
authors: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, U.K.
authors: Naveed
authors: N
authors: Sattar
authors: Institute of Health and Wellbeing, University of Glasgow, Glasgow, U.K. jill.pell@glasgow.ac.uk.
authors: Jill P
authors: JP
authors: Pell
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D018070:Biological Specimen Banks; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055105:Waist Circumference; D049629:Waist-Hip Ratio