Differences in type 2 diabetes risk between East, South, and Southeast Asians living in Singapore: the multi-ethnic cohort

Authors

Jowy Yi Seah, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore rvandam@gwu.edu jowy.seah.y.h@singhealth.com.sg.
Xueling Sim, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
Chin Meng Khoo, Division of Endocrinology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
E Shyong Tai, Division of Endocrinology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
Rob M. van Dam, Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore rvandam@gwu.edu jowy.seah.y.h@singhealth.com.sg.

Document Type

Journal Article

Publication Date

7-1-2023

Journal

BMJ open diabetes research & care

Volume

11

Issue

4

DOI

10.1136/bmjdrc-2023-003385

Keywords

BMI; ethnicity; insulin resistance; type 2 diabetes

Abstract

INTRODUCTION: Prospective data on differences in type two diabetes (T2D) risk between Asian ethnic groups are sparse. We, therefore, compared T2D risk for East (Chinese), South (Indian), and Southeast (Malay) Asians and examined biological factors that may contribute to ethnic differences. RESEARCH DESIGN AND METHODS: We included 7427 adults of Chinese, Malay, and Indian origin participating in the Singapore multi-ethnic cohort. Information on sociodemographic, lifestyle, and biological risk factors (body mass index (BMI), waist circumference, blood lipids, blood pressure, C reactive protein, adiponectin, and homeostasis model assessment for insulin resistance and beta-cell function) were collected using standardized interviews and physical examinations. T2D cases were based on physician diagnoses, a national medical registry, fasting plasma glucose, or glycated hemoglobin A1c. We used multivariable logistic association and mediation analyses. RESULTS: During an average follow-up of 7.2 years (SD 2.2 years), we documented 595 cases of incident diabetes. Ethnic Malays (OR 2.08, 95% CI 1.69 to 2.56) and Indians (OR 2.22, 95% CI 1.80 to 2.74) had an approximately twofold higher risk of T2D compared with ethnic Chinese. Higher BMI explained the higher risk for Malay compared with Chinese ethnicity. Higher BMI, waist circumference, inflammation, and insulin resistance, and lower beta-cell function and high-density lipoprotein-cholesterol significantly contributed to the higher T2D risk for Indian compared with Chinese ethnicity. However, part of the higher T2D risk associated with Indian ethnicity remained unexplained. Despite their lower diabetes risk, Chinese participants had the lowest adiponectin levels. CONCLUSIONS: Different Asian ethnic groups have unique biological risk factor profiles related to T2D development that may warrant targeted approaches for prevention and treatment.

APA Citation

Seah, Jowy Yi; Sim, Xueling; Khoo, Chin Meng; Tai, E Shyong; and van Dam, Rob M., "Differences in type 2 diabetes risk between East, South, and Southeast Asians living in Singapore: the multi-ethnic cohort" (2023). GW Authored Works. Paper 3131.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3131

Department

Exercise and Nutrition Sciences