Adolescent BMI and Early-Onset Type 2 Diabetes Among Ethiopian Immigrants and Their Descendants: A Nationwide Study.

Abstract

Background: We assessed in a nationwide cohort the association between adolescent BMI and early-onset (<40 years) type 2 diabetes among Israelis of Ethiopian origin. Methods: Normoglycemic adolescents (range 16-20 years old), including 93,806 native Israelis (≥3 rd generation in Israel) and 27,684 Israelis of Ethiopian origin, were medically assessed for military service between 1996 and 2011. Weight and height were measured. Data were linked to the Israeli National Diabetes Registry. Incident type 2 diabetes by December 31, 2016 was the outcome. Cox regression models stratified by sex and BMI categories were applied. Results: 226 (0.29%) men and 79 (0.18%) women developed diabetes during 992,980 and 530,814 person-years follow-up, respectively, at a mean age of 30.4 and 27.4 years, respectively. Among native Israeli men with normal and high (overweight and obese) BMI, diabetes incidence was 9.5 and 62.0 (per 10 5 person-years), respectively. The respective incidences were 46.9 and 112.3 among men of Ethiopian origin. After adjustment for sociodemographic confounders, the hazard ratios for type 2 diabetes among Ethiopian men with normal and high BMI were 3.4 (2.3-5.1) and 15.8 (8.3-30.3) respectively, compared to third-generation Israelis with normal BMI. When this analysis was limited to Israeli-born Ethiopian men, the hazard ratios were 4.4 (1.7-11.4) and 29.1 (12.9-70.6), respectively. Results persisted when immigrants of other white Caucasian origin were the reference; and among women with normal, but not high, BMI. Conclusions: Ethiopian origin is a risk factor for early-onset type 2 diabetes among young men at any BMI, and may require selective interventions.

Adolescent body mass index and changes in pre-pregnancy body mass index in relation to risk of gestational diabetes

“…As part of medical screening for military service, height and weight were measured (wearing light clothing) by trained medics, using a beam balance and stadiometer to the nearest centimeter and 0.1 kg, respectively [14,15]. BMI was calculated (weight [in kilograms] divided by squared height [in meters]).…”

“…As described previously [21], the cognitive assessment included four subdomains: Raven's Progressive Matrices-R, which measures nonverbal abstract reasoning and visual-spatial problem-solving abilities; Similarities-R, which assesses verbal abstraction and categorization; Otis-R, verbal comprehension, which assess the ability to understand and carry out verbal instructions; and Arithmetic-R, which assesses mathematical reasoning, concept manipulation and concentration [13]. The sum of the scores of all four tests constitutes a validated global score of overall intelligence [14]. Scored on a 90point scale, this overall score has demonstrated high correlation (r>0.8) with the Wechsler Adult Intelligence Scale (WAIS) total intelligence quotient (IQ) [13,14].…”

“…The sum of the scores of all four tests constitutes a validated global score of overall intelligence [14]. Scored on a 90point scale, this overall score has demonstrated high correlation (r>0.8) with the Wechsler Adult Intelligence Scale (WAIS) total intelligence quotient (IQ) [13,14].…”