Ethnic differences in the relationships between obesity and glucose-metabolic abnormalities: a cross-sectional population-based study

Int J Obes (Lond). 2005 Jun;29(6):656-67. doi: 10.1038/sj.ijo.0802937.


Objectives: To evaluate whether body mass index (BMI) and other anthropometric indices of visceral obesity vary by ethnic group in their distribution and their relationship to metabolic abnormalities.

Design: Cross-sectional study.

Participants: Canadian men and women, aged 35-75 years, of South Asian (n=342), Chinese (n=317), European (n=326) and Aboriginal (n=301) descent were recruited using stratified random sampling.

Primary measures: Anthropometric indices (BMI, waist to hip ratio (WHR) and waist circumference (WC)), metabolic markers (fasting glucose, HbA1c, the ratio of total cholesterol/HDL) and clinical markers (systolic blood pressure) were assessed.

Results: In subjects with BMI<30 kg/m2, the mean marker levels in people with elevated WC (>88 cm in women, >102 cm in men) vs people with normal WC were 6.16 vs 5.34 mmol/l for fasting glucose, 6.05 vs 5.66% for HbA1c and 5.46 vs 4.68 for the ratio of total cholesterol to HDL (P<0.001 in each case). At nearly every given level of BMI, non-European ethnic groups displayed significantly higher marker levels than Europeans. For example, for a given BMI, age and sex, the difference between European and non-European groups in HbA1c levels was 0.53% (95% confidence interval (CI): 0.37-0.69) for South Asians, 0.37% (95% CI: 0.2-0.54) for Chinese and 0.95% (95% CI: 0.78-1.12) for Aboriginal People.

Conclusions: Uniform cut-points for the classification of obesity using BMI, WHR or WC result in marked variation in the levels of glucose-metabolic abnormalities between ethnic groups. Existing action thresholds for these anthropometric indices do not apply to non-European ethnic groups and warrant revision.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asia, Southeastern / ethnology
  • Biomarkers / blood
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Blood Pressure
  • Body Mass Index
  • Canada
  • China / ethnology
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Europe / ethnology
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Indians, North American
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Obesity / blood
  • Obesity / ethnology*
  • Obesity / metabolism*
  • Reference Standards
  • Systole


  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • Glycated Hemoglobin A
  • Cholesterol