The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort.
BACKGROUND:Obesity is known to be a major risk factor for diabetes, but the magnitude of risk and variation between blacks and whites are less well documented in populations heavily affected by obesity. Herein we assess rates and risks of incident diabetes in a diverse southern population where obes...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5764338?pdf=render |
| _version_ | 1818544818410749952 |
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| author | Baqiyyah N Conway Xijing Han Heather M Munro Amy L Gross Xiao-Ou Shu Margaret K Hargreaves Wei Zheng Alvin C Powers William J Blot |
| author_facet | Baqiyyah N Conway Xijing Han Heather M Munro Amy L Gross Xiao-Ou Shu Margaret K Hargreaves Wei Zheng Alvin C Powers William J Blot |
| author_sort | Baqiyyah N Conway |
| collection | DOAJ |
| description | BACKGROUND:Obesity is known to be a major risk factor for diabetes, but the magnitude of risk and variation between blacks and whites are less well documented in populations heavily affected by obesity. Herein we assess rates and risks of incident diabetes in a diverse southern population where obesity is common. METHODS:A total of 24,000 black and 14,064 white adults aged 40-79 in the Southern Community Cohort Study with no self-reported diabetes at study enrollment during 2002-2009 was followed for up to 10 (median 4.5) years. Incidence rates, odds ratios (OR) and accompanying 95% confidence intervals (CI) for medication-treated incident diabetes were determined according to body mass index (BMI) and other characteristics, including tobacco and alcohol consumption, healthy eating and physical activity indices, and socioeconomic status (SES). RESULTS:Risk of incident diabetes rose monotonically with increasing BMI, but the trends differed between blacks and whites (pinteraction < .0001). Adjusted ORs (CIs) for diabetes among those with BMI≥40 vs 20-25 kg/m2 were 11.9 (8.4-16.8) for whites and 4.0 (3.3-4.8) for blacks. Diabetes incidence was more than twice as high among blacks than whites of normal BMI, but the racial difference became attenuated as BMI rose, with estimated 5-year probabilities of developing diabetes approaching 20% for both blacks and whites with BMI≥40 kg/m2. Diabetes risk was also associated with low SES, significantly (pinteraction≤.02) more so for whites, current cigarette smoking, and lower healthy eating and physical activity indices, although high BMI remained the predominant risk factor among both blacks and whites. From baseline prevalence and 20-year projections of the incidence trends, we estimate that the large majority of surviving cohort participants with BMI≥40 kg/m2 will be diagnosed with diabetes. CONCLUSIONS:Even using conservative criteria to ascertain diabetes incidence (i.e., requiring diabetes medication use and ignoring undiagnosed cases), rates of obesity-associated diabetes were exceptionally high in this low-income adult population. The findings indicate that effective strategies to halt the rising prevalence of obesity are needed to avoid substantial increases in diabetes in coming years. |
| first_indexed | 2024-12-11T22:53:25Z |
| format | Article |
| id | doaj.art-b89a65d32aec42ebb8db7cd810229c66 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T22:53:25Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b89a65d32aec42ebb8db7cd810229c662022-12-22T00:47:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01131e019099310.1371/journal.pone.0190993The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort.Baqiyyah N ConwayXijing HanHeather M MunroAmy L GrossXiao-Ou ShuMargaret K HargreavesWei ZhengAlvin C PowersWilliam J BlotBACKGROUND:Obesity is known to be a major risk factor for diabetes, but the magnitude of risk and variation between blacks and whites are less well documented in populations heavily affected by obesity. Herein we assess rates and risks of incident diabetes in a diverse southern population where obesity is common. METHODS:A total of 24,000 black and 14,064 white adults aged 40-79 in the Southern Community Cohort Study with no self-reported diabetes at study enrollment during 2002-2009 was followed for up to 10 (median 4.5) years. Incidence rates, odds ratios (OR) and accompanying 95% confidence intervals (CI) for medication-treated incident diabetes were determined according to body mass index (BMI) and other characteristics, including tobacco and alcohol consumption, healthy eating and physical activity indices, and socioeconomic status (SES). RESULTS:Risk of incident diabetes rose monotonically with increasing BMI, but the trends differed between blacks and whites (pinteraction < .0001). Adjusted ORs (CIs) for diabetes among those with BMI≥40 vs 20-25 kg/m2 were 11.9 (8.4-16.8) for whites and 4.0 (3.3-4.8) for blacks. Diabetes incidence was more than twice as high among blacks than whites of normal BMI, but the racial difference became attenuated as BMI rose, with estimated 5-year probabilities of developing diabetes approaching 20% for both blacks and whites with BMI≥40 kg/m2. Diabetes risk was also associated with low SES, significantly (pinteraction≤.02) more so for whites, current cigarette smoking, and lower healthy eating and physical activity indices, although high BMI remained the predominant risk factor among both blacks and whites. From baseline prevalence and 20-year projections of the incidence trends, we estimate that the large majority of surviving cohort participants with BMI≥40 kg/m2 will be diagnosed with diabetes. CONCLUSIONS:Even using conservative criteria to ascertain diabetes incidence (i.e., requiring diabetes medication use and ignoring undiagnosed cases), rates of obesity-associated diabetes were exceptionally high in this low-income adult population. The findings indicate that effective strategies to halt the rising prevalence of obesity are needed to avoid substantial increases in diabetes in coming years.http://europepmc.org/articles/PMC5764338?pdf=render |
| spellingShingle | Baqiyyah N Conway Xijing Han Heather M Munro Amy L Gross Xiao-Ou Shu Margaret K Hargreaves Wei Zheng Alvin C Powers William J Blot The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. PLoS ONE |
| title | The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. |
| title_full | The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. |
| title_fullStr | The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. |
| title_full_unstemmed | The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. |
| title_short | The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. |
| title_sort | obesity epidemic and rising diabetes incidence in a low income racially diverse southern us cohort |
| url | http://europepmc.org/articles/PMC5764338?pdf=render |
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