title: Diabetes Prevalence and Risk Factors in Four Asian American Communities.
abstract: Our objective was to estimate the prevalence of diabetes and pre-diabetes and the risk associated with BMI above the Asian cut-point of 23 in 4 Asian American communities. In a convenience sample of 981 Chinese, Hmong, Korean, and Vietnamese Americans in Sacramento County, California we measured hemoglobin A1c (HbAlc), height, weight, and waist circumference. Diabetes was defined as self-reported diabetes diagnosis or HbA1c ≥ 6.5 %, and pre-diabetes as HbAlc 5.7-6.4 % with no diabetes diagnosis. We computed age-standardized prevalence of diabetes, pre-diabetes, and BMI and waist circumference above standard and Asian cut-points, and developed multivariable models of the association of diabetes and pre-diabetes with BMI and waist circumference. The 4 ethnic groups differed substantially with respect to diabetes prevalence, BMI, and waist circumference. Hmong had the highest prevalence of diabetes (15.0 %, 95 % confidence interval [CI] 10.7-19.4 %). Diabetes and pre-diabetes were associated with BMI ≥ 25 (diabetes: odds ratio [OR] 3.4, 95 % CI 2.1-5.7; pre-diabetes: OR 4.0, 95 % CI 2.7-5.8) or between 23 and 25 (diabetes: OR 1.8, 95 % CI 1.0-3.1; pre-diabetes: OR 1.6, 95 % CI 1.0-2.4). When waist circumference was added to the model, BMI effects were attenuated, and waist circumference ≥40 inches (men) or ≥35 inches (women) was associated with increased risk of diabetes (OR 3.2, 95 % CI 1.6-6.2) and pre-diabetes (OR 1.7, 95 % CI 1.0-2.9). Our findings support the use of a BMI cut-point of 23 and the importance of central adiposity as a risk factor for diabetes in Asians. Diabetes risk reduction interventions for Asians are essential.
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Administrative Support Building (ASB), 2450 48th Street, Suite #1600, Sacramento, CA, 95817, USA. slstewart@ucdavis.edu.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stewart
authors.affiliation: Director of Community Engagement and Outreach, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Dang
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA.
authors.forename: Moon S
authors.initials: MS
authors.lastname: Chen
mesh_terms: D001208:Asia / Q000208:ethnology; D001213:Asian; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000208:ethnology; D011236:Prediabetic State; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055105:Waist Circumference
keywords: Adult diabetes; Asian; Body mass index; Pre-diabetes; Waist circumference