Ethnic differences in the risk of type 2 diabetes attributable to differences in abdominal adiposity in American women.

Abstract

To determine how much of the relative difference in the risk of type 2 diabetes between White and non-White (Black and Hispanic) American women can be explained by differences in the prevalence of abdominal obesity. Data from the Third National Health and Nutrition Examination Survey (n = 1572) were used in this investigation. The risk of type 2 diabetes and the population attributable fraction due to abdominal obesity were estimated using a logistic regression model adjusted for body mass index, age, smoking and alcohol consumption. The contribution of abdominal obesity to the development of diabetes within different ethnic groups and ethnic differences in the risk of diabetes were determined using the population attributable fraction and relative attributable risk, respectively, which compared Hispanic and Black women to White women. Abdominal obesity was associated with an increased risk of type 2 diabetes when adjusting for body mass index, age, smoking and alcohol consumption. The population attributable fractions indicated that 24.0, 39.9 and 15.7% of diabetes in White, Black and Hispanic women, respectively, could have been avoided if abdominal obesity was absent. Abdominal obesity accounted for 12.1% and 9.8% of ethnic differences in the risk of diabetes between White and Black women and between White and Hispanic women, respectively. A reduction in the risk of diabetes among Black and Hispanic women could be possible by instituting public health measures for reducing waist size to the levels seen in White women. Intervention programmes designed for reducing overall obesity and, consequently, waist size through lifestyle modification, including exercise and diet, may have considerable public health significance in reducing the incidence of type 2 diabetes in these populations.