Abstract 11629: Contributions of Socio-Economic Status, Lifestyle, and Biological Risk Factors to Ethnic Differences in Type 2 Diabetes Risk in a Multi-Ethnic Asian Population

Abstract

Introduction: There is no study that identified contributions of socio-economic status (SES), lifestyle, and biological risk factors to ethnic differences in T2D risk in Asia’s populous ethnic groups - Chinese, Malays and Indians. Methods: We used data of 7,427 participants from the Multiethnic Cohort, a population-based study of subjects aged ≥21 y. Information on SES and lifestyle were collected using standardized questionnaires. Biological risk factors were measured using validated methods. T2D cases were based on self-reported physician-diagnosed diabetes or a national medical registry, or fasting plasma glucose ≥7.0 mmol/L or HbA1c ≥6.5 %, after an average of 7.2 y (SD: 2.2 y). Multivariable logistic and linear regression models were used in association and mediation analyses. Results: In Model 1, Malays and Indians had a twofold higher risk of developing T2D compared with Chinese ( Table 2 ). In Model 2, only the association between Indians and Chinese remained. The higher T2D risk in Malays and Indians was largely mediated by BMI and HDL cholesterol ( Table 3 ). Adjusting for adiponectin concentrations widened the differences in T2D risk. We observed a larger mediation effect by HOMA-IR for Indians than Malays. Conclusion: The excess risk in Malays was completely explained by higher BMI. In contrast, neither adiposity nor SES and lifestyle could fully explain the higher T2D risk in Indians.