Ethnic specific obesity cut-offs for diabetes risk: cross-sectional study of 490, 288 UK Biobank participants

Ntuk, U., Gill, J. , Mackay, D. , Sattar, N. and Pell, J. (2014) Ethnic specific obesity cut-offs for diabetes risk: cross-sectional study of 490, 288 UK Biobank participants. Diabetes Care, 37(9), pp. 2500-2507. (doi: 10.2337/dc13-2966)

93767.pdf - Accepted Version



OBJECTIVE To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed in white populations in terms of diabetes prevalence.<p></p> RESEARCH DESIGN AND METHODS UK Biobank recruited 502,682 U.K. residents aged 40–69 years. We used baseline data on the 490,288 participants from the four largest ethnic subgroups: 471,174 (96.1%) white, 9,631 (2.0%) South Asian, 7,949 (1.6%) black, and 1,534 (0.3%) Chinese. Regression models were developed for the association between anthropometric measures (BMI, waist circumference, percentage body fat, and waist-to-hip ratio) and prevalent diabetes, stratified by sex and adjusted for age, physical activity, socioeconomic status, and heart disease.<p></p> RESULTS Nonwhite participants were two- to fourfold more likely to have diabetes. For the equivalent prevalence of diabetes at 30 kg/m2 in white participants, BMI equated to the following: South Asians, 22.0 kg/m2; black, 26.0 kg/m2; Chinese women, 24.0 kg/m2; and Chinese men, 26.0 kg/m2. Among women, a waist circumference of 88 cm in the white subgroup equated to the following: South Asians, 70 cm; black, 79 cm; and Chinese, 74 cm. Among men, a waist circumference of 102 cm equated to 79, 88, and 88 cm for South Asian, black, and Chinese participants, respectively.<p></p> CONCLUSIONS Obesity should be defined at lower thresholds in nonwhite populations to ensure that interventions are targeted equitably based on equivalent diabetes prevalence. Furthermore, within the Asian population, a substantially lower obesity threshold should be applied to South Asian compared with Chinese groups.<p></p>

Item Type:Articles
Additional Information:This is an author-created, uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association (ADA), publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes in print and online at
Glasgow Author(s) Enlighten ID:Gill, Professor Jason and Pell, Professor Jill and Mackay, Professor Daniel and Sattar, Professor Naveed
Authors: Ntuk, U., Gill, J., Mackay, D., Sattar, N., and Pell, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Diabetes Care
Publisher:American Diabetes Association
ISSN (Online):1935-5548
Copyright Holders:Copyright © 2014 American Diabetes Association
First Published:First published in Diabetes Care 37(9):2500-2507
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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