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Ethnic-Specific Obesity Cutoffs for Diabetes Risk: Cross-sectional Study of 490,288 UK Biobank Participants
Open accessAbstract
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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Metadata
- 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 › Endocrinology, Diabetes and Metabolism › 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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