Differences in Body Composition Convey a Similar Risk of Type 2 Diabetes Among Different Ethnic Groups With Disparate Cardiometabolic Risk—The HELIUS Study
Research Design and Methods: We used data from the HELIUS study, including individuals aged 18-70 of African Surinamese (n=3997), South-Asian Surinamese (n=2956), Turkish (n=3546), Moroccan (n=3850), Ghanaian (n=2271) and Dutch (n=4452) origin living in Amsterdam. Type 2 diabetes was defined using the World Health Organization criteria. Logistic regression was used to assess the relation between body composition and type 2 diabetes. Waist-hip ratio, waist circumference, BMI and body fat percentage by bio-electrical impedance were used to estimate body composition.
Results: Per unit change in BMI only Ghanaian [OR 0.94 (95% CI 0.89-0.99)] and Moroccan [0.94 (0.89-0.99)] women had a smaller increase in type 2 diabetes per unit change in BMI compared to the Dutch population, while OR for body fat percentage were 0.94 (0.89-1.00) for Ghanaian, 0.93 (0.88-0.99) for Moroccan and 0.95 (0.90-1.00) for South-Asian Surinamese women. There was no interaction between WHR and ethnicity on the risk of type 2 diabetes, and there were no differences in men. WHR had the highest precision in predicting type 2 diabetes in both men (c-statistic=0.78) and women (c-statistic=0.81).Conclusions: The association between differences in body composition and type 2 diabetes is roughly the same in all ethnic groups. WHR seems the most reliable and consistent predictor of type 2 diabetes regardless of ethnic background.