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The association of diabetes and BMI among Melanesian and Indian Fijians aged ≥ 40 years

  • Garry Brian (a1) (a2) (a3), Jacqueline Ramke (a1) (a4), Andrew Page (a5), Louise Maher (a1), John Szetu (a1) (a6) and Mundi Qalo Qoqonokana (a6)...

Abstract

The present study examines the association of diabetes with BMI (kg/m2) in Asian-Indian and Melanesian Fijian populations sharing a common environment. A population-based survey was used to investigate the risk of diabetes (defined by glycosylated Hb concentration ≥ 6·5 % among participants who denied previous diagnosis of the disease by a medical practitioner) by sex, ethnicity and strata of BMI in a series of age-adjusted logistic regression models. Ethnicity and BMI interactions were compared using WHO and empirically derived BMI cut-off points. Indians had a greater risk (BMI and age adjusted) of undetected diabetes than Melanesians in both males (OR 2·99, 95 % CI 1·73, 5·17; P < 0·001) and females (OR 2·26, 95 % CI 1·56, 3·28; P < 0·001). BMI ≥ 25 to < 30 and ≥ 30 kg/m2 conferred a higher risk of diabetes compared with a BMI ≥ 18·5 to < 25 kg/m2. Risk was higher for males with a BMI ≥ 25 to < 30 kg/m2 (OR 2·35, 95 % CI 1·24, 4·46; P = 0·007) and BMI ≥ 30 kg/m2 (OR 6·08, 95 % CI 3·06, 12·07; P < 0·001) than for females with the same BMI (OR 1·85, 95 % CI 1·11, 3·08; P = 0·027 and OR 2·10, 95 % CI 1·28, 3·44; P = 0·002, respectively). However, the threshold that appeared to differentiate higher risk varied by ethnicity and sex. For Melanesians, BMI thresholds suggested were 25 kg/m2 for males and 32 kg/m2 for females. For Indo-Fijians, these were 24 and 22 kg/m2 for males and females, respectively. Disaggregating by ethnicity and sex, and applying specific evidence-based thresholds, may render BMI a more discriminating tool for assessing the risk of developing diabetes among Fiji adults.

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Copyright

Corresponding author

*Corresponding author: G. Brian, fax +64 9 379 7178, email grbrian@tpg.com.au

References

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Keywords

The association of diabetes and BMI among Melanesian and Indian Fijians aged ≥ 40 years

  • Garry Brian (a1) (a2) (a3), Jacqueline Ramke (a1) (a4), Andrew Page (a5), Louise Maher (a1), John Szetu (a1) (a6) and Mundi Qalo Qoqonokana (a6)...

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