Immigration to Israel during childhood is associated with diabetes at adolescence: a study of 2.7 million adolescents

et al. 2020

Cardiovasc Diabetol

Self Cite

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 (≥ 3rd 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 105 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.

Section: Discussionsupporting

confidence: 91%

Adolescent BMI and early-onset type 2 diabetes among Ethiopian immigrants and their descendants: a nationwide study

et al. 2020

Cardiovasc Diabetol

Self Cite

“…(31) We report higher risk for type 2 diabetes among second-generation Israeli-born Ethiopian men than among those who immigrated; this association correlated with the time interval from immigration. Our ndings corroborate previous evidence that diabetes risk correlates with the time since immigration among immigrants from various ethnic backgrounds to Western countries, (32,33) and is higher among second-than rst-generation immigrants by 2-to 6-fold. (32,34) Similarly, African immigrants to the US were shown to be more likely to develop pre-diabetes or diabetes than African Americans, despite their having a higher level of education and lower BMI.…”

Section: Discussionsupporting

confidence: 91%

Adolescent BMI and early-onset type 2 diabetes among Ethiopian immigrants and their descendants: a nationwide study

et al. 2021

ESPE

Background: We assessed in a nationwide cohort the association between adolescent BMI and earlyonset (<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 strati ed 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.

“…(38) We report higher risk for type 2 diabetes among second-generation Israeli-born Ethiopian men than among those who immigrated; this association correlated with the time interval from immigration. Our ndings corroborate previous evidence that diabetes risk correlates with the time since immigration among immigrants from various ethnic backgrounds to Western countries, (39,40) and is higher among second-than rst-generation immigrants by 2-to 6-fold. (39,41) Similarly, African immigrants to the US were shown to be more likely to develop pre-diabetes or diabetes than African Americans, despite their having a higher level of education and lower BMI.…”

Section: Discussionsupporting

confidence: 91%

“…Our ndings corroborate previous evidence that diabetes risk correlates with the time since immigration among immigrants from various ethnic backgrounds to Western countries, (39,40) and is higher among second-than rst-generation immigrants by 2-to 6-fold. (39,41) Similarly, African immigrants to the US were shown to be more likely to develop pre-diabetes or diabetes than African Americans, despite their having a higher level of education and lower BMI. (8) Notably, no association was found between diabetes incidence and immigration status regarding immigration from the former USSR, which occurred in parallel to the Ethiopian immigration.…”

Section: Discussionsupporting

confidence: 91%

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

et al. 2020

Preprint

Self Cite

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.