Diabetes Prevalence and Risk Factors in Four Asian American Communities

Abstract

Objective To estimate the prevalence of diabetes and pre-diabetes and the risk associated with BMI above the Asian cut-point of 23 in 4 Asian American communities. Research Design and Methods In a convenience sample of 981 Chinese, Hmong, Korean, and Vietnamese Americans in Sacramento County, California we measured hemoglobin A1c (HbAlc), height, weight, and waist circumference. Diabetes was defined as self-reported diabetes diagnosis or HbA1c ≥ 6.5%, and pre-diabetes as HbAlc 5.7%-6.4% with no diabetes diagnosis. We computed age-standardized prevalence of diabetes, pre-diabetes, and BMI and waist circumference above standard and Asian cut-points, and developed multivariable models of the association of diabetes and pre-diabetes with BMI and waist circumference. Results The 4 ethnic groups differed substantially with respect to diabetes prevalence, BMI, and waist circumference. Hmong had the highest prevalence of diabetes (15.0%, 95% confidence interval [CI] 10.7%-19.4%). Diabetes and pre-diabetes were associated with BMI ≥ 25 (diabetes: odds ratio [OR] =3.4, 95% CI 2.1-5.7; pre-diabetes: OR=4.0, 95% CI 2.7-5.8) or between 23 and 25 (diabetes: OR=1.8, 95% CI 1.0-3.1; pre-diabetes: OR=1.6, 95% CI 1.0-2.4). When waist circumference was added to the model, BMI effects were attenuated, and waist circumference ≥ 40 inches (men) or ≥ 35 inches (women) was associated with increased risk of diabetes (OR=3.2, 95% CI 1.6-6.2) and pre-diabetes (OR=1.7, 95% CI 1.0-2.9). Conclusions Our findings support the use of a BMI cut-point of 23 and the importance of central adiposity as a risk factor for diabetes in Asians. Diabetes risk reduction interventions for Asians are essential.

The Asian American Network for Cancer Awareness, Research, and Training (AANCART)'s contributions toward reducing Asian American cancer health disparities, 2000‐2017

“…We collaborated with other CNPCs in publishing our findings with others who researched perceptions of whites and Hispanics . We also applied our experience in collecting blood biospecimens to characterize various risk factors for hepatocellular carcinoma and diabetes and are currently analyzing the potential of the genetic propensity toward liver cancer from the Hmong blood biospecimens we collected.…”

High frequency of the PNPLA3 rs738409 [G] single‐nucleotide polymorphism in Hmong individuals as a potential basis for a predisposition to chronic liver disease

“…HCC risk factors included waist circumference, BMI, blood pressure, cholesterol, smoking status, diabetes status, and HBV status. While the Hmong are a relatively small Asian group, their distinctiveness as the population experiencing the lowest liver cancer survival rates among all Californians, 8 means that adding a genetic dimension to our prior data on their considerable behavioral risk factors 9 for chronic liver disease expands our insights into contributing etiologies. Having these findings suggest that a high rate of the PNPLA3 SNV should be examined further.…”

“…There are different risk factors for NAFLD. 4 Among Asians in Sacramento County, California, Hmong experience the highest prevalence of metabolic risk factors for HCC, such as diabetes, large waist circumference, and high body mass index (BMI), 9 as well as chronic HBV infections. 10 However, the biological basis for the disparity is ill-defined and understudied.…”

Time, trust, and transparency: Lessons learned from collecting blood biospecimens for cancer research from the Asian American community

“…The more biospecimens we have from diverse populations, the closer we get to understanding the mechanism behind biologic, molecular, and cancer population research. For example, the biospecimens collected in this study have been used to characterize Asian American cancer risk factors based on clinical diagnosis (rather than self‐report), and the community blood biospecimens have been the basis for positing that the high frequency of the PNPLA3 rs738409 (G) single‐nucleotide polymorphism may potentially explain the genetic predisposition for chronic liver disease among Hmong …”