Ethnic differences and determinants of diabetes and central obesity among South Asians of Pakistan

Jun 24, 2004Diabetic medicine : a journal of the British Diabetic Association

Ethnic differences and factors linked to diabetes and belly fat in South Asians from Pakistan

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Abstract

The age-standardized prevalence of diabetes is highest among the Muhajirs at 5.7% for men and 7.9% for women.

Diabetes prevalence varies significantly among South Asian ethnic subgroups, with Muhajirs showing the highest rates.
Urban residents are more likely to have diabetes than rural residents, although this difference is less pronounced after accounting for central obesity.
Ethnic disparities in diabetes persist even after adjusting for major sociodemographic factors.
Central obesity also varies among ethnic groups and by gender, but does not directly correlate with diabetes prevalence.
Unmeasured environmental or genetic factors may contribute to the observed ethnic variations in diabetes and central obesity.

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AIMS: To study the within ethnic subgroup variations in diabetes and central obesity among South Asians.

METHODS: Data from 9442 individuals age > or = 15 years from the National Health Survey of Pakistan (NHSP) (1990-1994) were analysed. Diabetes was defined as non-fasting blood glucose > or = 7.8 mmol/l, or known history of diabetes. Central obesity was measured at the waist circumference. Distinct ethnic subgroups Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi were defined by mother tongue.

RESULTS: The age-standardized prevalence of diabetes varied among ethnic subgroups (P = 0.002), being highest among the Muhajirs (men 5.7%, women 7.9%), then Punjabis (men 4.6%, women 7.2%), Sindhis (men 5.1%, women 4.8%), Pashtuns (men 3.0%, women 3.8%), and lowest among the Baluchis (men 2.9%, women 2.6%). While diabetes was more prevalent in urban vs. rural dwellers [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.24, 1.82], this difference was no longer significant after adjusting for central obesity (OR 1.15, 95% CI 0.95, 1.42). However, the ethnic differences persisted after adjusting for major sociodemographic risk factors (unadjusted OR for Pashtun vs. Punjabi 0.59, 95% CI 0.42, 0.84, adjusted OR 0.54, 95% CI 0.37, 0.78). Ethnic variation was also observed in central obesity, which varied with gender, and did not necessarily track with ethnic differences in diabetes.

CONCLUSIONS: Unmeasured environmental or genetic factors account for ethnic variations in diabetes and central obesity, and deserve further study.

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Ethnic differences and determinants of diabetes and central obesity among South Asians of Pakistan

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