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Diabetes Care. 1998 Nov;21(11):1828-35.

Differential effects of BMI on diabetes risk among black and white Americans.

Author information

  • 1Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Maryland 20892, USA. resnickh@nih.gov

Abstract

OBJECTIVE:

To determine whether the associations of BMI and fat distribution with diabetes risk are modified by race.

RESEARCH DESIGN AND METHODS:

Data from the National Health and Nutrition Examination Survey, Epidemiologic Follow-up Study (1971-1992), were used to investigate potential interactions of BMI and fat distribution with race. Incident diabetes was defined by self-report of physician-diagnosed diabetes, hospital and nursing home discharge records, and death certificates.

RESULTS:

Among the 1,531 black and 9,852 white subjects who were nondiabetic at baseline, 1,139 (10.0%) developed diabetes during 20 years of follow-up. Although the cumulative risk of diabetes increased with baseline BMI in all four race-sex groups, the sex-specific odds ratios (ORs) for black:white subjects decreased with increasing BMI. In particular, for BMI of 22 kg/m2, the OR of diabetes for black:white individuals was 1.87 and 1.76 (P < 0.01) for men and women, respectively; for BMI of 32 kg/m2, the OR decreased to 0.99 and 1.20 (NS) for men and women, respectively. Skinfold ratio was also associated with increased diabetes risk in all race-sex groups, but did not modify the association between race and diabetes.

CONCLUSIONS:

These findings suggest that the effect of BMI on diabetes risk is different for black and white Americans, with a larger risk for blacks than whites at low BMI and an equivalent risk for both groups at high BMI. A lower degree of visceral adiposity among blacks at higher BMI or a greater impact of visceral adiposity among blacks at low BMI may help explain the interaction of race and BMI on diabetes risk.

PMID:
9802729
[PubMed - indexed for MEDLINE]
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