The Fred Hollows Foundation New Zealand, Newmarket, Auckland, New Zealand.
Br J Nutr. 2011 May;105(10):1539-45. doi: 10.1017/S0007114510005258. Epub 2011 Jan 24.
The present study examines the association of diabetes with BMI (kg/m(2)) in Asian-Indian and Melanesian Fijian populations sharing a common environment. A population-based survey was used to investigate the risk of diabetes (defined by glycosylated Hb concentration ≥ 6·5 % among participants who denied previous diagnosis of the disease by a medical practitioner) by sex, ethnicity and strata of BMI in a series of age-adjusted logistic regression models. Ethnicity and BMI interactions were compared using WHO and empirically derived BMI cut-off points. Indians had a greater risk (BMI and age adjusted) of undetected diabetes than Melanesians in both males (OR 2·99, 95 % CI 1·73, 5·17; P < 0·001) and females (OR 2·26, 95 % CI 1·56, 3·28; P < 0·001). BMI ≥ 25 to < 30 and ≥ 30 kg/m(2) conferred a higher risk of diabetes compared with a BMI ≥ 18·5 to < 25 kg/m(2). Risk was higher for males with a BMI ≥ 25 to < 30 kg/m(2) (OR 2·35, 95 % CI 1·24, 4·46; P = 0·007) and BMI ≥ 30 kg/m(2) (OR 6·08, 95 % CI 3·06, 12·07; P < 0·001) than for females with the same BMI (OR 1·85, 95 % CI 1·11, 3·08; P = 0·027 and OR 2·10, 95 % CI 1·28, 3·44; P = 0·002, respectively). However, the threshold that appeared to differentiate higher risk varied by ethnicity and sex. For Melanesians, BMI thresholds suggested were 25 kg/m(2) for males and 32 kg/m(2) for females. For Indo-Fijians, these were 24 and 22 kg/m(2) for males and females, respectively. Disaggregating by ethnicity and sex, and applying specific evidence-based thresholds, may render BMI a more discriminating tool for assessing the risk of developing diabetes among Fiji adults.
本研究旨在探讨在具有共同环境的亚洲印度人和美拉尼西亚斐济人群中，糖尿病与 BMI（kg/m²）之间的关联。本研究采用基于人群的调查，通过一系列经年龄调整的逻辑回归模型，按性别、种族和 BMI 分层，调查参与者中糖尿病的患病风险（通过糖化血红蛋白浓度≥6.5%定义，参与者否认曾被医生诊断患有该疾病）。采用世界卫生组织（WHO）和经验性 BMI 切点比较种族和 BMI 之间的相互作用。印度人在男性（调整 BMI 和年龄后，OR 2.99，95%CI 1.73，5.17；P<0.001）和女性（调整 BMI 和年龄后，OR 2.26，95%CI 1.56，3.28；P<0.001）中，糖尿病的未检出风险均高于美拉尼西亚人。与 BMI≥18.5 至<25 kg/m²相比，BMI≥25 至<30 kg/m²和 BMI≥30 kg/m² 与糖尿病风险增加相关。对于 BMI≥25 至<30 kg/m²的男性（OR 2.35，95%CI 1.24，4.46；P=0.007）和 BMI≥30 kg/m²的男性（OR 6.08，95%CI 3.06，12.07；P<0.001），糖尿病风险高于同 BMI 的女性（OR 1.85，95%CI 1.11，3.08；P=0.027 和 OR 2.10，95%CI 1.28，3.44；P=0.002）。然而，似乎因种族和性别而异，区分更高风险的阈值也不同。对于美拉尼西亚人，男性的 BMI 阈值为 25 kg/m²，女性的 BMI 阈值为 32 kg/m²。对于印度斐济人，男性和女性的 BMI 阈值分别为 24 和 22 kg/m²。按种族和性别细分，并应用基于证据的特定阈值，可能使 BMI 成为评估斐济成年人患糖尿病风险的更具区分度的工具。
