Ethnic variations in diabetes and prediabetes prevalence and the roles of insulin resistance and β-cell function: The CARRS and NHANES studies

• Type of Material: Article
• Authors: UP Gujral, Emory University; V Mohan, IDF Centre of Education; R Pradeepa, IDF Centre of Education; M Deepa, IDF Centre of Education; RM Anjana, IDF Centre of Education; Neil Mehta, Emory University; EW Gregg, Centers for Disease Control and Prevention; Kabayam Venkat Narayan, Emory University
• Language: English
• Date: 2016-06-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2016 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jcte.2016.02.004
• Title of Journal or Parent Work: Journal of Clinical and Translational Endocrinology
• ISSN: 2214-6237
• Volume: 4
• Start Page: 19
• End Page: 27
• Grant/Funding Information: The CARRS study is funded in whole or in part by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, MN, USA.
• Keywords: Type 2 Diabetes; Asian Indian; Ethnicity
• Research Categories: Health Sciences, Public Health

Abstract

Aims: It is unclear how the prevalence of diabetes in Asian Indians in urban India compares to that of race/ethnic groups in the US that may have different underlying susceptibilities. Therefore, we examined ethnic variations in the prevalence of type 2 diabetes, iIFG, iIGT, IFG + IGT, and the associated risk factors in Asian Indians in Chennai, India, and Whites, Blacks, and Hispanics in the United States. Methods: Cross-sectional analyses, using representative samples of 4867 Asian Indians aged 20–74 years from Chennai, India, in the Centre for Cardiometabolic Risk Reduction in South-Asia study (CARRS) (2010–2011) and 6512 US Whites, Blacks, and Hispanics aged 20–74 years from the National Health and Nutrition Examination Survey (NHANES) (2007–2012). Results: The age-adjusted prevalence of type 2 diabetes was highest in Asian Indians (men: 28.4, 95% CI: 25.9, 31.0; women: 30.6, 95% CI, 27.5, 33.9) and lowest in Caucasians (men: 12.2, 95% CI, 10.3, 14.4, women: 9.5, 95% CI, 7.9, 11.5). Asian Indians had the lowest prediabetes prevalence (men: 19.0, 95% CI, 17.2, 20.8; women: 27.2, 95% CI, 22.8, 32.1) and Caucasians had the highest (men; 46.5, 95% CI, 43.5, 49.6, women: 34.4, 95% CI, 31.7, 37.3). However, there were differences in prediabetes prevalence by gender and prediabetes state. The inclusion of HOMA-β in standardized polytomous logistic regression models resulted in a greater odds of diabetes in Blacks and Hispanics compared to Asian Indians. Conclusions: The high prevalence of diabetes in Asian Indians may be due to innate susceptibilities for β-cell dysfunction in this high risk population.