title: Ethnic differences in associations between fat deposition and incident diabetes and underlying mechanisms: the SABRE study.
abstract: OBJECTIVE
  To examine ethnic differences in ectopic fat and associations with incident diabetes.
  
  
  METHODS
  In a UK cohort study, 1338 Europeans, 838 South Asians, and 330 African Caribbeans living in London were aged 40-69 years at baseline. Baseline assessment included blood tests, anthropometry, and questionnaires. Anthropometry-based prediction equations estimated baseline visceral adipose tissue (VAT). Incident diabetes was ascertained from record review, self-report, or oral glucose tolerance testing.
  
  
  RESULTS
  South Asians had more and African Caribbeans less estimated VAT than Europeans. Both ethnic minorities had larger truncal skinfolds than Europeans. In men, adjustment for risk factors (BMI, smoking, systolic blood pressure, and HDL-cholesterol) markedly attenuated the association between estimated VAT and diabetes in Europeans (standardized subhazard ratios [95% CI]: from 1.74 [1.49, 2.03] to 1.16 [0.77, 1.76]) and African Caribbeans (1.72 [1.26, 2.35] to 1.44 [0.69, 3.02]) but not South Asians (1.60 [1.38, 1.86] to 1.90 [1.37, 2.64]). In women, attenuation was observed only for South Asians (1.80 [1.01, 3.23] to 1.07 [0.49, 2.31]). Associations between truncal skinfolds and diabetes appeared less affected by multivariable adjustment in South Asians and African Caribbeans than Europeans (1.24 [0.97, 1.57] and 1.28 [0.89, 1.82] versus 1.02 [0.77, 1.36] in men; 1.91 [1.03, 3.56] and 1.42 [0.86, 2.34] versus 1.23 [0.74, 2.05] in women).
  
  
  CONCLUSIONS
  Differences in overall truncal fat, as well as VAT, may contribute to the excess of diabetes in South Asian and African Caribbean groups, particularly for women.
authors: Institute of Cardiovascular Science, University College London, UK.
authors: Sophie V
authors: SV
authors: Eastwood
authors: Therese
authors: T
authors: Tillin
authors: Hakim-Moulay
authors: HM
authors: Dehbi
authors: Andrew
authors: A
authors: Wright
authors: Nita G
authors: NG
authors: Forouhi
authors: Ian
authors: I
authors: Godsland
authors: Peter
authors: P
authors: Whincup
authors: Naveed
authors: N
authors: Sattar
authors: Alun D
authors: AD
authors: Hughes
authors: Nishi
authors: N
authors: Chaturvedi
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D050218:Body Fat Distribution / Q000706:statistics & numerical data; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology* / Q000378:metabolism; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000378:metabolism; D044465:White People
chemical_list: D008076:Cholesterol, HDL
references: Arterioscler Thromb Vasc Biol. 2008 Jun;28(6):1039-49
references: 18356555
references: Obesity (Silver Spring). 2008 Mar;16(3):600-7
references: 18239557
references: Diabetologia. 2009 Oct;52(10):2079-86
references: 19641896
references: Obesity (Silver Spring). 2010 Feb;18(2):274-81
references: 19661963
references: Diabetes Care. 2011 Jun;34(6):1415-8
references: 21505210
references: Lancet. 2011 Jul 2;378(9785):31-40
references: 21705069
references: PLoS One. 2011;6(7):e22112
references: 21829446
references: Diabetologia. 2011 Nov;54(11):2795-800
references: 21837509
references: Int J Epidemiol. 2012 Feb;41(1):33-42
references: 21044979
references: Obesity (Silver Spring). 2012 Jun;20(6):1293-300
references: 22282045
references: JAMA. 2012 Sep 19;308(11):1150-9
references: 22990274
references: Diabetes Care. 2013 Feb;36(2):383-93
references: 22966089
references: Nutrients. 2013 Feb;5(2):498-508
references: 23434905
references: Diabetologia. 2013 Oct;56(10):2238-49
references: 23811809
references: Diabetes Care. 2000 Apr;23(4):465-71
references: 10857936
references: JAMA. 2000 May 3;283(17):2253-9
references: 10807384
references: PLoS One. 2013;8(9):e75085
references: 24069381
references: Arterioscler Thromb Vasc Biol. 2000 Aug;20(8):1932-8
references: 10938014
references: Pediatrics. 2002 Nov;110(5):e54
references: 12415060
references: Am J Clin Nutr. 2003 May;77(5):1192-7
references: 12716671
references: Eur J Epidemiol. 2004;19(8):751-60
references: 15469032
references: Am J Physiol. 1985 Jul;249(1 Pt 2):R1-12
references: 4014489
references: J R Soc Health. 1995 Apr;115(2):90-5
references: 7738997
references: J Clin Invest. 1995 Jul;96(1):88-98
references: 7615840
references: Stat Methods Med Res. 1996 Dec;5(4):339-55
references: 9004377
references: Diabetes Care. 1998 Dec;21(12):2191-2
references: 9839117
references: Diabetes. 1999 Aug;48(8):1586-92
references: 10426377
references: Diabetes Care. 1999 Sep;22(9):1462-70
references: 10480510
references: Diabetologia. 2005 Feb;48(2):301-8
references: 15660262
references: Indian Pediatr. 2005 Jun;42(6):527-38
references: 15995269
references: Arch Intern Med. 2006 Feb 13;166(3):350-6
references: 16476877
references: Epidemiol Rev. 2007;29:115-28
references: 17494056
references: Diabetes Care. 2009 Jun;32(6):1068-75
references: 19244087