Body Composition and Diabetes Risk in South Asians: Findings From the MASALA and MESA Studies

Diabetes Care. 2019 May;42(5):946-953. doi: 10.2337/dc18-1510. Epub 2019 Feb 22.

Abstract

Objective: South Asians have a higher prevalence of type 2 diabetes compared with other race/ethnic groups. Body composition is associated with the risk for type 2 diabetes. Differences in body composition between South Asians and other race/ethnic groups are one hypothesized mechanism to explain the disproportionate prevalence of type 2 diabetes in this population.

Research design and methods: This study used data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) cohorts to determine whether body composition mediated the elevated prevalence of impaired fasting glucose and type 2 diabetes in South Asians. Participants (n = 2,615) with complete body composition data were included. Ordinal logistic regression models were calculated to determine the odds for glycemic impairment in South Asians compared with the MESA cohort.

Results: In multivariate models, South Asians had a significantly higher prevalence of glycemic impairment and type 2 diabetes compared with all four race/ethnic groups included in the MESA (P < 0.001 for all). In unadjusted and multivariate adjusted models, South Asians had higher odds for impaired fasting glucose and type 2 diabetes compared with all other race/ethnic groups (P < 0.001 for all). The addition of body composition measures did not significantly mitigate this relationship.

Conclusions: We did not identify strong evidence that accounting for body composition explains differences in the risk for type 2 diabetes. Future prospective studies of the MESA and MASALA cohorts are needed to understand how adipose tissue impacts the risk for type 2 diabetes and how to best assess this risk.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Asia / ethnology
  • Asian Americans / statistics & numerical data*
  • Atherosclerosis / epidemiology
  • Atherosclerosis / ethnology
  • Atherosclerosis / metabolism
  • Body Composition / physiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / ethnology*
  • Diabetes Mellitus, Type 2 / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prediabetic State / epidemiology
  • Prediabetic State / ethnology
  • Prediabetic State / metabolism
  • Prevalence
  • Risk Factors
  • United States / epidemiology