Black New Yorkers with Type 2 Diabetes: Afro-Caribbean Immigrants Have Lower BMI and Lower Waist Circumference than African Americans.

Abstract

Using the 2013/2014 New York City (NYC) Health and Nutrition Examination Survey (NYCHANES) data, this exploratory study examined whether (a) type 2 diabetes (diabetes) prevalence differed between NYC Afro-Caribbeans and African Americans; (b) anthropometric, biochemical, and sociodemographic diabetes profiles differed between and within groups; and (c) diabetes odds differed between and within groups. Diabetes was defined as prior diagnosis, HbA1c ≥ 6.5% (7.8mmol/L), or fasting glucose ≥ 126mg/dL. Weighted logistic regression estimated diabetes odds by nativity and either waist circumference (WC) (cm) or BMI (kg/m2). All regression models controlled for age, hypertension, gender, education, income, marital status, physical activity, and smoking. Among Afro-Caribbeans (n = 81, 65% female, age (mean ± SE) 49 ± 2years, BMI 29.2 ± 0.7kg/m2) and African Americans (n = 118, 50% female, age 47 ± 2years, BMI 30.3 ± 0.9kg/m2), Afro-Caribbeans with diabetes had lower BMI (29.9 ± 0.8kg/m2 vs. 34.6 ± 1.7kg/m2, P = 0.01) and lower WC (102 ± 2cm vs. 114 ± 3cm, P = 0.002) than African Americans with diabetes. Afro-Caribbeans with diabetes had lower prevalence of obesity (33.2% vs. 74.7%) and higher prevalence of overweight (57.2% vs. 13.5%) (P = 0.02) than African Americans with diabetes. Odds of diabetes did not differ between Afro-Caribbeans and African Americans. In models predicting the effect of WC, diabetes odds increased with WC (OR = 1.07 (95% CI 1.02, 1.11), P = 0.003) and age (OR = 1.09 (95% CI 1.03-1.15), P = 0.003) for African Americans only. In models predicting the effect of BMI, diabetes odds increased for Afro-Caribbeans with age (OR = 1.06 (1.01, 1.11)*, P = 0.04) and hypertension (OR = 5.62 (95% CI 1.04, 30.42), P = 0.045), whereas for African Americans, only age predicted higher diabetes odds (OR = 1.08 (95% CI 1.03, 1.14), P = 0.003). In NYC, Afro-Caribbeans with diabetes have lower BMI and lower WC than African Americans with diabetes, but odds of diabetes do not differ. Combining African-descent populations into one group obscures clinical differences and generalizes diabetes risk.