Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project

Abstract

OBJECTIVE: To investigate the relationship between fasting glucose and 2 h glucose with percentage of Hawaiian ancestry and ethnic admixture. DESIGN: Cross-sectional epidemiological study of type 2 diabetes and heart disease risk factor prevalence among Native Hawaiians. SUBJECTS: A total of 578 Native Hawaiians residing in two rural communities were examined between 1993 and 1996. Sample sizes in statistical analyses varied due to missing data and selection criteria based on ethnic ancestry. MEASUREMENTS: Percentage of Hawaiian ancestry and non-Hawaiian ethnic admixture, assessed by self-report. Fasting and 2 h post glucose challenge plasma glucose levels. Anthropometric measures (height, weight, waist and hip circumferences). Selfreport of diet and physical activity. Medical history. RESULTS: Increased Hawaiian blood quantum was significantly associated with increased fasting glucose (P ¼ 0.0047), increased body mass index (BMI; P < 0.0001), waist-to-hip ratio (WHR; P ¼ 0.0103), and age (P < 0.0001), but not with leisure time physical activity and total dietary caloric intake. This association was attenuated after adjusting for BMI and WHR, but not by age-adjustment alone. However, when the effects of descent from other ethnic groups was examined in a subset of participants, full-Hawaiians had significantly higher fasting glucose concentrations (7.28 mmol=l) than part-Hawaiians after adjustments for age, gender, BMI and WHR. In contrast, part-Hawaiians of predominantly Asian ancestry had the highest 2 h glucose concentrations (7.62 mmol=l). CONCLUSION: These results suggest that ethnic admixture may be an important, but extremely complex, factor concerning the high prevalence of type 2 diabetes observed among this population. The complexity of this relationship may have obscured the relationship between ancestry and glucose tolerance in earlier observations of this population.

Disparity in Diabetes Risk Across Native Hawaiians and Different Asian Groups

“…29 This agrees with the current relative risk of only 1.58 for Native Hawaiians after re-classifying those with any Asian ancestry as Part-Asian, whereas anyone with any Native Hawaiian ancestry had a risk of 1.93. 7 Asian admixture may augment diabetes risk in Native Hawaiians beyond the contribution of obesity.…”

“…This important but complex factor may have obscured the relation between ancestry and diabetes susceptibility in previous reports. 29 …”

Major dietary patterns, ethnicity, and prevalence of type 2 diabetes in rural Hawaii

“…Kosaka (13), therefore, proposed two types of T2DM that progress differently among different ethnicities. One type is obesity-associated insulin resistance, in which insulin resistance due to obesity precedes the development of diabetes (14); the other is non-obesity type with impaired insulin secretion, in which reduction of insulin secretion among the non-obese population precedes development of the disease (10,13,15). Not only are there genetic differences in diabetes etiology, but also different dietary patterns among ethnic groups may interact with both types at T2DM, leading to a varying disease prevalence in ethnic groups.…”

Hyperglycemia and type 2 diabetes among Filipino women in the Philippines, Hawaii, and San Diego

“…Hawaii (HI)-The Native Hawaiian Health Research Project, a population-based, crosssectional study to determine the association between cardiovascular risk factors, glucose intolerance, insulin resistance, and ethnicity, conducted a multi-ethnic study from 1997 to 2001 [1,20]. Participants included a comparison cohort of Filipinos, ≥18 years of age, who were recruited from a rural community (North Kohala) on the island of Hawaii, using census data for door-to-door sampling.…”