title: Impact of classical risk factors of type 2 diabetes among Asian Indian, Chinese and Japanese populations.
abstract: OBJECTIVE
  This review investigated the population impact of major modifiable type 2 diabetes (T2D) risk factors, with special focus on native Asian Indians, to estimate population attributable risks (PARs) and compare them with estimates from Chinese and Japanese populations.
  
  
  METHODS
  Information was obtained on risk factors in 21,041 Asian Indian, 17,774 Chinese and 17,986 Japanese populations from multiple, large, cross-sectional studies (the DECODA project) of T2D. Crude and adjusted PARs were estimated for the major T2D risk factors.
  
  
  RESULTS
  Age had the highest crude and adjusted PARs among Asian Indians and Chinese in contrast to waist-hip ratio among Japanese. After adjusting for age, the PAR for body mass index (BMI) in Asian Indians (41.4% [95% CI: 37.2%; 45.4%]) was second only to triglycerides (46.4% [95% CI: 39.5%; 52.8%]) compared with 35.8% [95% CI: 29.9%; 41.4%] in Japanese and 38.4% [95% CI: 33.5%; 43.2%] in Chinese people. The PAR for BMI adjusted for age, LDL and triglycerides (39.7% [95% CI: 31.6%; 47.2%]) was higher than for any other factor in Asian Indians, and was much higher than in the Chinese (16.8% [95% CI: 3.0%; 30.9%]) and Japanese (30.4% [95% CI: 17.5%; 42.2%]) populations.
  
  
  CONCLUSIONS
  This review provides estimates of the association between major risk factors and prevalences of T2D among Asian populations by examining their PARs from large population-based samples. From a public-health point of view, the importance of BMI in Asian Indians is especially highlighted in comparison to the other Asian populations. Given these results and other recent findings on the causality link between BMI and T2D, it can be postulated that obesity may be involved in the aetiology of T2D through interaction with ethnic-specific genetic factors, although ethnicity itself is not a direct risk factor for T2D as people of all ethnic backgrounds develop diabetes.
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland. Electronic address: liang.he@helsinki.fi.
authors.forename: L
authors.initials: L
authors.lastname: He
authors.affiliation: Centre for Vascular Prevention, Danube-University Krems, 3500 Krems, Austria; Chronic Disease Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, 21589 Jeddah, Saudi Arabia.
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland.
authors.forename: Q
authors.initials: Q
authors.lastname: Qiao
authors.affiliation: Department of Public Health and Clinical Medicine, Cardiology, Umeå University, Umeå, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Söderberg
authors.affiliation: Department of Neurology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, Yamagata, Japan; Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Daimon
authors.affiliation: Department of Epidemiology and Biostatistics, Imperial College London, London W2 1NY, United Kingdom; Imperial College Healthcare NHS Trust, Hammersmith Hospital, London W12 0HS, United Kingdom; Royal Brompton and Harefield Hospitals NHS Trust, London SW3 6NP, United Kingdom; Ealing Hospital NHS Trust, Southall, Middlesex UB1 3HW, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Chambers
authors.affiliation: Department of Public Health, University of Helsinki, P.O. Box 41, 00014 Helsinki, Finland; Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Pitkäniemi
mesh_terms: D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D015228:Hypertriglyceridemia / Q000503:physiopathology*; D015994:Incidence; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D015995:Prevalence; D012307:Risk Factors; D065927:Waist-Height Ratio
keywords: Asian populations; Population attributable risk; Prevalence; Risk factors; Type 2 diabetes mellitus