Ethnic-specific obesity cutoffs for diabetes risk: cross-sectional study of 490,288 UK biobank participants
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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. RESEARCH DESIGN AND 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/m2 in white participants, BMI equated to the following: South Asians, 22.0 kg/m2; black, 26.0 kg/m2; Chinese women, 24.0 kg/m2; and Chinese men, 26.0 kg/m2. 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.
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Redistribution of body fat into ectopic sites occurs with ageing, possibly even without weight regain.
“redistribution of body fat into ectopic sites occurs with ageing, 30,31 possibly even without weight regain”
From 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study (2024) · cites this paper as [31]
The Discussion says that body fat may be deposited in the abdomen and liver at a lower BMI in some ethnic groups, but it does not link that deposition to ageing. Searches for ageing-related fat redistribution and weight gain found no passage addressing whether it occurs with age or without weight regain. No page number is available in our copy. (LLM, conf=0.76)
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- Authors
- Ntuk, U. E., Gill, J. M. R., Mackay, D. F., Sattar, N., & Pell, J. P.
- Affiliations
- University of Glasgow (GB)
- Corresponding author
- Pell, Jill P.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2014-08-07
- Volume
- 37
- Issue
- 9
- Pages
- 2500-2507
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2157288306
- Cited by
- 220
- References
- 31
- Citations by year
- 2026: 12 · 2025: 26 · 2024: 14 · 2023: 14 · 2022: 18 · 2021: 21 · 2020: 17 · 2019: 12 · 2018: 21 · 2017: 23 · 2016: 17 · 2015: 20 · 2014: 5
- FWCI
- 17.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Funders
- Wellcome Trust (093707)
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- diabetes risk, ethnic differences, South Asian ethnicity, Black ethnicity, Chinese ethnicity, body mass index, waist circumference, waist-to-hip ratio, body fat percentage, diabetes prevalence, UK Biobank
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Diabetes Mellitus, Ethnicity, Female, United Kingdom, Humans, Male, Middle Aged, Obesity, Risk Factors, Body Mass Index, Prevalence, Biological Specimen Banks, Waist-Hip Ratio, Adiposity, Waist Circumference
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