Abstract
BackgroundDespite higher levels of obesity, West African migrant women appear to have lower rates of type 2 diabetes than their male counterparts. We investigated the role of body fat distribution in these differences.MethodsCross-sectional study of Ghanaian migrants (97 men, 115 women) aged 18–60 years in Amsterdam, the Netherlands. Weight, height, waist and hip circumferences were measured. Logistic regression was used to explore the association of BMI, waist and hip measurements with elevated fasting glucose (glucose≥5.6 mmol/L). Linear regression was used to study the association of the same parameters with fasting glucose.ResultsMean BMI, waist and hip circumferences were higher in women than men while the prevalence of elevated fasting glucose was higher in men than in women, 33% versus 19%. With adjustment for age only, men were non-significantly more likely than women to have an elevated fasting glucose, odds ratio (OR) 1.81, 95% CI: 0.95, 3.46. With correction for BMI, the higher odds among men increased and were statistically significant (OR 2.84, 95% CI: 1.32, 6.10), but with consideration of body fat distribution (by adding both hip and waist in the analysis) differences were no longer significant (OR 1.56 95% CI: 0.66, 3.68). Analysis with fasting glucose as continuous outcome measure showed somewhat similar results.ConclusionCompared to men, the lower rates of elevated fasting glucose observed among Ghanaian women may be partly due to a more favorable body fat distribution, characterized by both hip and waist measurements.
Highlights
West African migrants form a significant proportion of the population in many industrialized countries
Average fasting glucose levels did not differ between men and women, but men were more often categorized as having an elevated fasting glucose (EFG) than women
Smoking levels were low in this population (1%) and did not differ between the sexes, as did either physical activity level or highest attained education level
Summary
West African migrants form a significant proportion of the population in many industrialized countries. In 2008, the International Organization for Migration estimated that there are approximately 800,000 registered West African migrants in the main European receiving countries [1]. African migrants to Western Europe often have high levels of overweight and obesity and related chronic diseases [3]. Available evidence indicates that it is women who are affected most by obesity [4,5], suggesting that women are likely to have the highest risk of obesity related chronic disease such as type 2 diabetes mellitus (DM). Information on the health of this migrant group is limited [3], but there are indications that, contrary to expectations, DM is more common among men than women. Despite higher levels of obesity, West African migrant women appear to have lower rates of type 2 diabetes than their male counterparts. We investigated the role of body fat distribution in these differences
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