Objective: We evaluated whether the longitudinal association between BMI and 10-year risk of developing T2DM occurred at lower BMI points among Chinese Americans, Hispanics, and African Americans compared to whites.

Research Design and Methods: We used data from the Multi-Ethnic Study of Atherosclerosis (2000-2013), a cohort of adults ages 45-85 without cardiovascular disease at baseline. Incident T2DM was defined as fasting glucose ≥126 mg/dL and/or use of a diabetes medication. We used multivariable Weibull regressions adjusting for age, sex, education, dietary quality (Alternative Healthy Eating Index and kcal/day), and exercise to estimate the association between BMI and incident T2DM by race/ethnicity. BMI was modelled with a 3-knot restricted cubic spline to capture non-linear associations.

Results: Among 4,541 participants without prevalent T2DM, 557 incident T2DM cases occurred in a median 9.1 years of follow-up. The corresponding BMI points and their respective 95% CIs for a 10% risk of T2DM over 10 years were 22.2 (20.4, 24), 24.5 (21, 28), 25.5 (24.2, 26.8) and 28 (26.5, 29.5) for Chinese-Americans, Hispanics, African Americans, and whites, respectively.

Conclusion: Race/ethnic minority groups develop T2DM at lower BMI compared to whites. Our findings support the ADA-recommended BMI≥23 for Asians and BMI≥25 for other groups for T2DM screening.

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Disclosure

L.A. Rodriguez: None. P.T. Bradshaw: None. S. Shiboski: None. A. Fernandez: None. E. Vittinghoff: None. D.M. Herrington: None. J. Ding: None. A.M. Kanaya: None.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (F31DK115029)

© 2019 by the American Diabetes Association.
2019
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