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Diabetes incidence based on linkages with health plans: the multiethnic cohort.

Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN, Schmidt MM, Uchida A, Juarez DT, Hodges K, Kolonel LN - Diabetes (2009)

Bottom Line: We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48.However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Center, University of Hawaii, Honolulu, Hawaii, USA. gertraud@crch.hawaii.edu

ABSTRACT

Objective: Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.

Research design and methods: After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999-2000), a medication questionnaire (2003-2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.

Results: After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.

Conclusions: Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

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Related in: MedlinePlus

Diabetes risk by ethnicity and BMI. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and education). Caucasians with a BMI <22 kg/m2 are the reference category.
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Figure 2: Diabetes risk by ethnicity and BMI. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and education). Caucasians with a BMI <22 kg/m2 are the reference category.

Mentions: Cox regression models stratified by age at cohort entry and adjusted for sex, BMI, and education showed results similar to unadjusted incidence rates. Japanese Americans and Native Hawaiians were twice as likely to be diagnosed with diabetes as Caucasians with HRs 2.65 (95% CI 2.52–2.78) and 1.93 (1.82–2.06), respectively. The respective HRs for BMI were 2.10 (1.94–2.26), 4.12 (3.83–4.43), and 9.48 (8.77–10.25). When we examined the combined effect of BMI and ethnicity (Fig. 2), diabetes risk for Japanese Americans and Native Hawaiians was higher than for Caucasians at all BMI levels. In comparison with the reference category of Caucasians with a BMI <22 kg/m2, the HR for Caucasian obese subjects was 15.51 (12.78–18.82), whereas for obese Native Hawaiians and Japanese Americans the respective HRs were 24.47 (20.17–29.67) and 30.76 (25.30–37.40). Even for individuals with a BMI of 22.0–24.9 kg/m2, the risk was significantly elevated for all ethnic groups.


Diabetes incidence based on linkages with health plans: the multiethnic cohort.

Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN, Schmidt MM, Uchida A, Juarez DT, Hodges K, Kolonel LN - Diabetes (2009)

Diabetes risk by ethnicity and BMI. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and education). Caucasians with a BMI <22 kg/m2 are the reference category.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2712787&req=5

Figure 2: Diabetes risk by ethnicity and BMI. Data are HRs and 95% CIs from the Cox regression analysis (adjusted for age, sex, and education). Caucasians with a BMI <22 kg/m2 are the reference category.
Mentions: Cox regression models stratified by age at cohort entry and adjusted for sex, BMI, and education showed results similar to unadjusted incidence rates. Japanese Americans and Native Hawaiians were twice as likely to be diagnosed with diabetes as Caucasians with HRs 2.65 (95% CI 2.52–2.78) and 1.93 (1.82–2.06), respectively. The respective HRs for BMI were 2.10 (1.94–2.26), 4.12 (3.83–4.43), and 9.48 (8.77–10.25). When we examined the combined effect of BMI and ethnicity (Fig. 2), diabetes risk for Japanese Americans and Native Hawaiians was higher than for Caucasians at all BMI levels. In comparison with the reference category of Caucasians with a BMI <22 kg/m2, the HR for Caucasian obese subjects was 15.51 (12.78–18.82), whereas for obese Native Hawaiians and Japanese Americans the respective HRs were 24.47 (20.17–29.67) and 30.76 (25.30–37.40). Even for individuals with a BMI of 22.0–24.9 kg/m2, the risk was significantly elevated for all ethnic groups.

Bottom Line: We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48.However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category.

View Article: PubMed Central - PubMed

Affiliation: Cancer Research Center, University of Hawaii, Honolulu, Hawaii, USA. gertraud@crch.hawaii.edu

ABSTRACT

Objective: Using the Hawaii component of the Multiethnic Cohort (MEC), we estimated diabetes incidence among Caucasians, Japanese Americans, and Native Hawaiians.

Research design and methods: After excluding subjects who reported diabetes at baseline or had missing values, 93,860 cohort members were part of this analysis. New case subjects were identified through a follow-up questionnaire (1999-2000), a medication questionnaire (2003-2006), and linkage with two major health plans (2007). We computed age-standardized incidence rates and estimated hazard ratios (HRs) for ethnicity, BMI, education, and combined effects of these variables using Cox regression analysis.

Results: After a total follow-up time of 1,119,224 person-years, 11,838 incident diabetic case subjects were identified with an annual incidence rate of 10.4 per 1,000 person-years. Native Hawaiians had the highest rate with 15.5, followed by Japanese Americans with 12.5, and Caucasians with 5.8 per 1,000 person-years; the adjusted HRs were 2.65 for Japanese Americans and 1.93 for Native Hawaiians. BMI was positively related to incidence in all ethnic groups. Compared with the lowest category, the respective HRs for BMIs of 22.0-24.9, 25.0-29.9, and > or =30.0 kg/m(2) were 2.10, 4.12, and 9.48. However, the risk was highest for Japanese Americans and intermediate for Native Hawaiians in each BMI category. Educational achievement showed an inverse association with diabetes risk, but the protective effect was limited to Caucasians.

Conclusions: Within this multiethnic population, diabetes incidence was twofold higher in Japanese Americans and Native Hawaiians than in Caucasians. The significant interaction of ethnicity with BMI and education suggests ethnic differences in diabetes etiology.

Show MeSH
Related in: MedlinePlus