Type 2 Diabetes Phenotype in a Small Isolated Zapotec-Speaking Community in the Valley of Oaxaca, Southern Mexico

Abstract

Objective: To test the hypothesis that the type 2 diabetes mellitus (T2DM) phenotype in an indigenous population is characterized by proportionally short legs and obesity. Methods: Anthropometric characteristics were compared in females and males with T2DM (n = 20, n = 8, respectively) and without T2DM (n = 117, n = 93, respectively). Factor analysis derived dimensions were regressed on T2DM in logistic regression. Results: Weight, sitting height ratio and hip circumference were significantly lower (p < 0.0001) in females, while waist: hip ratio was significantly higher among women and men with T2DM (p < 0.0001 and p < 0.008, respectively). Arm circumference, triceps skinfold, arm muscle circumference, and right and left grip strength were significantly lower among T2DM women (p < 0.0001 for each). Five rotated principal components accounted for 86.7% of the variance: muscular (grip) strength (29.6%), body mass (27.9%), central adiposity (10.7%), body height (9.3%), and trunk length (9.2%). Regression of factors on T2DM status among females indicated muscle strength (OR = 0.16, 95% CI: 0.04-0.71) and central adiposity (OR = 13.76, 95% CI: 3.80-49.83) were predictors of T2DM. In males, muscle strength (OR = 0.28, 95% CI: 0.07-1.08, p < 0.06) and central adiposity significantly predicted T2DM (OR = 3.17, 95% CI: 95% 1.11-9.04, p < 0.008). Conclusion: Reduced muscle strength/mass and increased central adiposity characterize the T2DM phenotype.