Article Text
Abstract
Objective Prevalence of type 2 diabetes varies by region and ancestry. However, most guidelines for the prevention of diabetes mellitus (DM) are based on European or non-Hispanic white populations. Two ethnic minority populations—Mexican Americans (MAs) in Texas, USA, and South Indians (SIs) in Tamil Nadu, India—have an increasing prevalence of DM. We aimed to understand the metabolic correlates of DM in these populations to improve risk stratification and DM prevention.
Research design and methods The Cameron County Hispanic Cohort (CCHC; n=3023) served as the MA sample, and the Population Study of Urban, Rural, and Semi-Urban Regions for the Detection of Endovascular Disease (PURSE; n=8080) served as the SI sample. Using design-based methods, we calculated the prevalence of DM and metabolic comorbidities in each cohort. We determined the association of DM with metabolic phenotypes to evaluate the relative contributions of obesity and metabolic health to the prevalence of DM.
Results In the CCHC (overall DM prevalence 26.2%), good metabolic health was associated with lower prevalence of DM, across age groups, regardless of obesity. In PURSE (overall prevalence 27.6%), probability of DM was not strongly associated with metabolic phenotypes, although DM prevalence was high in older age groups irrespective of metabolic health.
Conclusion Our study provides robust, population-based data to estimate the prevalence of DM and its associations with metabolic health. Our results demonstrate differences in metabolic phenotypes in DM, which should inform DM prevention guidelines in non-European populations.
- Type 2 Diabetes
- Asian
- Mexican Americans
- Population-based Studies
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Footnotes
Contributors GPW compiled and analyzed data, and drafted the manuscript. MHR contributed statistical expertise and edited the manuscript. SPF-H is the principal investigator of the CCHC, and contributed expertise and editing to the manuscript. JBMcC provided clinical expertise and edited the manuscript. ML contributed to the discussion and revised the manuscript. ACC contributed expertise and edited the manuscript. ST is the principal investigator of the PURSE-HIS cohort. MT conceived the study and contributed expertise to the manuscript.
Funding The CCHC was supported by the Center for Clinical and Translational Sciences, which is funded by National Institutes of Health Clinical and Translational Award no. UL1 TR000371 from the National Center for Advancing Translational Sciences. Gordon Watt was supported by a the Predoctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant R25 CA057712. The PURSE-HIS study was supported by a grant from the Drugs and Pharmaceutical Research Program under Technology Development and Transfer Division, Department of Science and Technology, Government of India, project no. VI-D&P/151/06-07/TDT, and by Sri Ramachandra University.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Advancing Translational Sciences, National Cancer Institute, National Institutes of Health, or the Government of India.
Competing interests None declared.
Patient consent Not required.
Ethics approval The CCHC has been approved by the Committee for the Protection of Human Subjects at the University of Texas Health Science Center at Houston, and PURSE has been approved by the Institutional Ethics Committee of Sri Ramachandra University.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Analytic data sets for the CCHC and PURSE are available upon request from the principal investigators of the respective cohorts (CCHC, SPF-H; PURSE, MT). SAS code for data management and analysis are available from the corresponding author (SPF-H).