Race ranks higher than pounds in diabetes, heart-health risks

April 3, 2017, University of California, San Francisco
This is an image of a weight scale. Credit: CDC/Debora Cartagena

Americans of South Asian descent are twice as likely as whites to have risks for heart disease, stroke and diabetes, when their weight is in the normal range, according to a study headed by Emory University and UC San Francisco.

Similarly, Americans of Hispanic descent were 80 percent more likely than whites to suffer from so-called cardio-metabolic abnormalities that give rise to , stroke and diabetes, compared with 50 percent more likely for those who were Chinese and African-American.

These risks include (hypertension), elevated glucose, low HDL, the "good cholesterol," and high triglycerides, a fat found in blood. In the study, participants who were aged between 45 and 84, were classified as having cardio-metabolic abnormalities if they had two or more of these four risk factors.

The study, publishing April 3, 2017 in Annals of Internal Medicine, included 803 South Asian residents of San Francisco Bay and Chicago areas, who traced their ancestry to India, Pakistan, Nepal, Bangladesh or Sri Lanka. Also enrolled in a parallel study were approximately 6,000 residents of New York, Baltimore, Chicago, Los Angeles, Minneapolis-St. Paul and Winston-Salem areas, who identified as Chinese, white, Hispanic or African-American.

For whites, Hispanics and African-Americans, normal weight was categorized as having a body mass index (BMI) between18. 5 and 24.9 kg/m2. For Chinese and South Asians, the range was narrower: from 18.5 to 22.9 kg/m2.

1st Study to Look at Differences Between 5 Races

Questionnaires were given to assess participants' activity levels and eating habits.

"While other studies have looked at race and cardio-metabolic risk, this is the first that looks at the relative differences between five races," said senior author Alka Kanaya, MD, professor of medicine, epidemiology and biostatistics in the Division of Internal Medicine at UC San Francisco. "It's also the first that compared risk between two different Asian populations."

The researchers found that for non-whites to have the same number of cardio-metabolic risk factors as whites with a BMI of 25 kg/m2 - the equivalent of 150 pounds for a woman measuring 5-foot-5—they had to have much lower BMI levels. These were 22.9 kg/m2 for African-Americans, 21.5 kg/m2 for Hispanics, 20.9 kg/m2 for Chinese and 19.6 kg/m2 for South Asians - the equivalent of 118 pounds for a woman measuring 5-foot-5.

"These differences are not explained by differences in demographic, health behaviors or body fat location," said first author Unjali Gujral, PhD, a postdoctoral fellow at the Global Diabetes Research Center at Emory University in Atlanta. "Clinicians using overweight/obesity as the main criteria for cardio-metabolic screening, as currently recommended by the U.S. Preventive Services Task Force, may fail to identify cardio-metabolic abnormalities in many patients from racial/ethnic minority groups."

Kanaya, who is also the principal investigator of the MASALA study (Mediators of Atherosclerosis in South Asians Living in America), which enrolled the South Asians, said that the results of the study should not be interpreted as a call to those with normal BMI to lose weight.

"We hope the results will enable patients and their health care providers to see that race/ethnicity alone may be a risk factor for cardio-metabolic health in minority Americans," she said.

Explore further: MASALA study examines south asian heart disease risks

More information: Study: annals.org/aim/article/doi/10.7326/M16-1895
Patient summary: annals.org/aim/article/doi/10.7326/P17-9036

Related Stories

MASALA study examines south asian heart disease risks

April 7, 2016
To keep a person's heart healthy, clinicians recommend avoiding risk factors such as smoking or excessive weight gain. But one risk factor, which cannot be changed, is being South Asian.

Risk of T2DM at different BMIs varies with ethnicity

March 13, 2017
(HealthDay)—The risk of developing type 2 diabetes mellitus (T2DM) associated with body mass index (BMI) varies between ethnic groups, according to a study published online Feb. 17 in Diabetes, Obesity and Metabolism.

Asian-Americans are at high risk for diabetes but rarely get screened

November 15, 2016
Less than half of Asian Americans who ought to be screened for type 2 diabetes actually get tested, according to a study published Nov. 15, 2016, in the Journal of General Internal Medicine. Asian Americans have a high prevalence ...

More years lost for whites versus South Asians, blacks with T2DM

December 27, 2016
(HealthDay)—Whites with type 2 diabetes have more life years lost than South Asians or blacks, according to a study published online Dec. 20 in Diabetes Care.

Pacific Islanders, South Asians and Filipinos have higher rates of diabetes than all other ethnic groups

October 16, 2012
(Medical Xpress)—Rates of diagnosed diabetes are much higher among some Asian subgroups than is apparent when aggregating all Asians as a whole, according to a new study by the Kaiser Permanente Division of Research and ...

Common virus tied to diabetes, heart disease in women under 50

February 23, 2017
A type of herpes virus that infects about half of the U.S. population has been associated with risk factors for type 2 diabetes and heart disease in normal-weight women aged 20 to 49, according to a new UC San Francisco-led ...

Recommended for you

Genetic discovery may help better identify children at risk for type 1 diabetes

January 17, 2018
Six novel chromosomal regions identified by scientists leading a large, prospective study of children at risk for type 1 diabetes will enable the discovery of more genes that cause the disease and more targets for treating ...

Thirty-year study shows women who breastfeed for six months or more reduce their diabetes risk

January 16, 2018
In a long-term national study, breastfeeding for six months or longer cuts the risk of developing type 2 diabetes nearly in half for women throughout their childbearing years, according to new Kaiser Permanente research published ...

Women who have gestational diabetes in pregnancy are at higher risk of future health issues

January 16, 2018
Women who have gestational diabetes mellitus (GDM) during pregnancy have a higher than usual risk of developing type 2 diabetes, hypertension, and ischemic heart disease in the future, according to new research led by the ...

Diabetes gene found that causes low and high blood sugar levels in the same family

January 15, 2018
A study of families with rare blood sugar conditions has revealed a new gene thought to be critical in the regulation of insulin, the key hormone in diabetes.

Discovery could lead to new therapies for diabetics

January 12, 2018
New research by MDI Biological Laboratory scientist Sandra Rieger, Ph.D., and her team has demonstrated that an enzyme she had previously identified as playing a role in peripheral neuropathy induced by cancer chemotherapy ...

Enzyme shown to regulate inflammation and metabolism in fat tissue

January 11, 2018
The human body has two primary kinds of fat—white fat, which stores excess calories and is associated with obesity, and brown fat, which burns calories in order to produce heat and has garnered interest as a potential means ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.