Background Asian adults develop Type 2 diabetes at a lower body mass index (BMI) compared to other racial/ethnic groups. We examined the variation in prevalence of prediabetes and diabetes among Asian ethnic groups within weight strata by comparing middle-aged Chinese, Filipino, South Asian, and White adults receiving care in the same integrated healthcare delivery system. Methods Our retrospective cross-sectional U.S. study examined data from 283,110 (non-Hispanic) White, 33,263 Chinese, 38,766 Filipino, and 17,959 South Asian adults aged 45–64 years who were members of a Northern California health plan in 2016 and had measured height and weight. Prediabetes and diabetes were classified based on laboratory data, clinical diagnoses, or diabetes pharmacotherapy. Age-standardized prevalence of prediabetes and diabetes were compared by race/ethnicity within healthy weight, overweight, and obesity categories, using standard BMI thresholds for White adults (18.5 to < 25, 25 to < 30, ≥ 30 kg/m2) and lower BMI thresholds for Asian adults (18.5 to < 23, 23 to < 27.5, ≥ 27.5 kg/m2). Prevalence ratios (PRs) were used to compare the prevalence of diabetes and prediabetes for Asian groups to White adults in each weight category, adjusted for age and BMI. Results Across all weight categories, diabetes prevalence was higher for Asian than White adults, and among Asian groups it was highest for Filipino and South Asian adults. Compared to White, PRs for South Asian men/women at healthy BMI were 1.8/2.8 for prediabetes and 5.9/8.0 for diabetes, respectively. The PRs for Filipino men/women at healthy BMI were 1.8/2.6 for prediabetes and 5.0/7.5 for diabetes, respectively. For Chinese men/women at healthy BMI, the PRs for prediabetes (2.1/2.9) were similar to Filipino and South Asian, but the PRs for diabetes were lower (2.1/3.4). Conclusion Chinese, Filipino, and South Asian adults have higher prevalence of prediabetes and diabetes than White adults in all weight categories, despite using lower BMI thresholds for weight classification in Asian groups. Within Asian ethnic groups, Filipino and South Asian adults had considerably higher diabetes prevalence than Chinese adults. Our data emphasize the disproportionate metabolic risk among middle-aged Asian adults and underscore the need for diabetes screening among high-risk Asian groups at healthy BMI levels.

Objectives Polycystic Ovary Syndrome (PCOS) is a common female endocrine disorder presenting as early as adolescence. Recent data suggest that Asians may be at increased risk. This study examines PCOS prevalence by race/ethnicity in a large, diverse population of adolescent females. Methods This retrospective study included 244,642 females (ages 13–17) with well-child visits during 2012–2018 in a Northern California healthcare system. Race/ethnicity and Asian ethnicity were classified using self-reported data. Body mass index was classified as healthy, overweight, and moderate/severe obesity. PCOS was determined by clinical diagnosis within one year of the visit. Results The overall prevalence of PCOS was 0.7% and increased substantially with weight. Among those with obesity, PCOS prevalence was 4.2, 2.9, 2.4, 2.1% in Asian/Pacific Islander (PI), Hispanic/Latina, Non-Hispanic White, Black adolescents and 7.8, 6.7, 5.7, 3.4% in South Asian, Chinese, Filipina, Native Hawaiian/PI adolescents, respectively. Compared to White adolescents, Asian/PIs had two-fold higher risk of PCOS, and Hispanic/Latinas had 1.3-fold higher risk. Compared to Chinese adolescents, South Asians had 1.7-fold higher risk, while Native Hawaiian/PIs had half the risk. Conclusions The increased burden of diagnosed PCOS in Asian/PI and Hispanic/Latina adolescents, especially those with obesity, calls for further examination and clinical surveillance of at-risk populations.

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Introduction: Prevalence of polycystic ovary syndrome (PCOS) and diabetes (DM), two cardiometabolic conditions (CMCs), vary by ethnicity in Asian women. Hypertension (HTN) also varies by ethnicity, but this has not been well studied in young Asian women with CMCs. We examined whether HTN diagnosis (Dx) in Asians varies by ethnicity, independent of body mass index (BMI), PCOS and DM. Methods: We used electronic health record data from a large US health plan to examine prevalence of HTN (≥2 Dx) in a cohort of 19,258 Chinese, 23,213 Filipina, and 19,108 South Asian women aged 21-44 years for whom BMI, PCOS (≥2 Dx) and DM (≥2 Dx + DM treatment) were ascertained. The associations of ethnicity and CMCs with HTN were examined using multivariable logistic regression. Results: Prevalence of HTN was 2% among Chinese and South Asian and 8% among Filipina women. Across all ethnic groups, compared to women with no CMCs, HTN prevalence was highest among those with DM and somewhat higher among those with PCOS and obesity. For all CMCs, Filipinas had the highest HTN prevalence (Figure). Adjusting for age, smoking, BMI, CMCs, and ethnicity, the odds of HTN were higher for Filipinas (2.6; CI 2.3-2.9) and slightly lower for South Asians (0.9; CI 0.7-0.98) compared to Chinese women; DM was associated with 4.7-fold higher odds (CI 4.1-5.3) and PCOS 1.4-fold higher odds (CI 1.1-1.8) of HTN. Conclusion: In young Asian women, DM, PCOS and obesity are associated with greater HTN burden. Compared to Chinese women, Filipinas have higher odds and South Asian women lower odds of HTN independent of BMI, PCOS, and DM. These data suggest a need for heightened BP surveillance in young Filipina women and Asian women with obesity or CMCs.