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BMJ Open Diabetes Res Care. 2018 Mar 20;6(1):e000436. doi: 10.1136/bmjdrc-2017-000436. eCollection 2018.

Mexican American and South Asian population-based cohorts reveal high prevalence of type 2 diabetes and crucial differences in metabolic phenotypes.

Author information

1
Brownsville Regional Campus, The University of Texas Health Science Center at Houston School of Public Health, Brownsville, Texas, USA.
2
Division of Epidemiology, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, USA.
3
PURSE-HIS Study Center, Sri Ramachandra University, Chennai, Tamil Nadu, India.
4
Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA.

Abstract

Objective:

Prevalence of type 2 diabetes varies by region and ancestry. However, most guidelines for the prevention of diabetes mellitus (DM) are based on European or non-Hispanic white populations. Two ethnic minority populations-Mexican Americans (MAs) in Texas, USA, and South Indians (SIs) in Tamil Nadu, India-have an increasing prevalence of DM. We aimed to understand the metabolic correlates of DM in these populations to improve risk stratification and DM prevention.

Research design and methods:

The Cameron County Hispanic Cohort (CCHC; n=3023) served as the MA sample, and the Population Study of Urban, Rural, and Semi-Urban Regions for the Detection of Endovascular Disease (PURSE; n=8080) served as the SI sample. Using design-based methods, we calculated the prevalence of DM and metabolic comorbidities in each cohort. We determined the association of DM with metabolic phenotypes to evaluate the relative contributions of obesity and metabolic health to the prevalence of DM.

Results:

In the CCHC (overall DM prevalence 26.2%), good metabolic health was associated with lower prevalence of DM, across age groups, regardless of obesity. In PURSE (overall prevalence 27.6%), probability of DM was not strongly associated with metabolic phenotypes, although DM prevalence was high in older age groups irrespective of metabolic health.

Conclusion:

Our study provides robust, population-based data to estimate the prevalence of DM and its associations with metabolic health. Our results demonstrate differences in metabolic phenotypes in DM, which should inform DM prevention guidelines in non-European populations.

KEYWORDS:

Asian; Mexican Americans; Population-based Studies; Type 2 Diabetes

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