Body mass index and diabetes in Asia: A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium

Paolo Boffetta, Dale McLerran, Yu Chen, Manami Inoue, Rashmi Sinha, Jiang He, Prakash Chandra Gupta, Shoichiro Tsugane, Fujiko Irie, Akiko Tamakoshi, Yu Tang Gao, Xiao Ou Shu, Renwei Wang, Ichiro Tsuji, Shinichi Kuriyama, Keitaro Matsuo, Hiroshi Satoh, Chien Jen Chen, Jian Min Yuan, Keun Young YooHabibul Ahsan, Wen Harn Pan, Dongfeng Gu, Mangesh Suryakant Pednekar, Shizuka Sasazuki, Toshimi Sairenchi, Gong Yang, Yong Bing Xiang, Masato Nagai, Hideo Tanaka, Yoshikazu Nishino, San Lin You, Woon Puay Koh, Sue K. Park, Chen Yang Shen, Mark Thornquist, Daehee Kang, Betsy Rolland, Ziding Feng, Wei Zheng, John D. Potter

Research output: Contribution to journalArticle

Abstract

Background: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. Methods and Findings: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 Kg/m 2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m 2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m 2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. Conclusions: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

Original languageEnglish (US)
Article numbere19930
JournalPLoS One
Volume6
Issue number6
DOIs
StatePublished - 2011

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Medical problems
cross-sectional studies
body mass index
diabetes
Body Mass Index
Cross-Sectional Studies
Bangladesh
Obesity
Odds Ratio
Population
India
Logistic Models
Confidence Intervals
odds ratio
Singapore
Korea
Taiwan
obesity
Alcohol Drinking
Meta-Analysis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Body mass index and diabetes in Asia : A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium. / Boffetta, Paolo; McLerran, Dale; Chen, Yu; Inoue, Manami; Sinha, Rashmi; He, Jiang; Gupta, Prakash Chandra; Tsugane, Shoichiro; Irie, Fujiko; Tamakoshi, Akiko; Gao, Yu Tang; Shu, Xiao Ou; Wang, Renwei; Tsuji, Ichiro; Kuriyama, Shinichi; Matsuo, Keitaro; Satoh, Hiroshi; Chen, Chien Jen; Yuan, Jian Min; Yoo, Keun Young; Ahsan, Habibul; Pan, Wen Harn; Gu, Dongfeng; Pednekar, Mangesh Suryakant; Sasazuki, Shizuka; Sairenchi, Toshimi; Yang, Gong; Xiang, Yong Bing; Nagai, Masato; Tanaka, Hideo; Nishino, Yoshikazu; You, San Lin; Koh, Woon Puay; Park, Sue K.; Shen, Chen Yang; Thornquist, Mark; Kang, Daehee; Rolland, Betsy; Feng, Ziding; Zheng, Wei; Potter, John D.

In: PLoS One, Vol. 6, No. 6, e19930, 2011.

Research output: Contribution to journalArticle

Boffetta, P, McLerran, D, Chen, Y, Inoue, M, Sinha, R, He, J, Gupta, PC, Tsugane, S, Irie, F, Tamakoshi, A, Gao, YT, Shu, XO, Wang, R, Tsuji, I, Kuriyama, S, Matsuo, K, Satoh, H, Chen, CJ, Yuan, JM, Yoo, KY, Ahsan, H, Pan, WH, Gu, D, Pednekar, MS, Sasazuki, S, Sairenchi, T, Yang, G, Xiang, YB, Nagai, M, Tanaka, H, Nishino, Y, You, SL, Koh, WP, Park, SK, Shen, CY, Thornquist, M, Kang, D, Rolland, B, Feng, Z, Zheng, W & Potter, JD 2011, 'Body mass index and diabetes in Asia: A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium', PLoS One, vol. 6, no. 6, e19930. https://doi.org/10.1371/journal.pone.0019930
Boffetta, Paolo ; McLerran, Dale ; Chen, Yu ; Inoue, Manami ; Sinha, Rashmi ; He, Jiang ; Gupta, Prakash Chandra ; Tsugane, Shoichiro ; Irie, Fujiko ; Tamakoshi, Akiko ; Gao, Yu Tang ; Shu, Xiao Ou ; Wang, Renwei ; Tsuji, Ichiro ; Kuriyama, Shinichi ; Matsuo, Keitaro ; Satoh, Hiroshi ; Chen, Chien Jen ; Yuan, Jian Min ; Yoo, Keun Young ; Ahsan, Habibul ; Pan, Wen Harn ; Gu, Dongfeng ; Pednekar, Mangesh Suryakant ; Sasazuki, Shizuka ; Sairenchi, Toshimi ; Yang, Gong ; Xiang, Yong Bing ; Nagai, Masato ; Tanaka, Hideo ; Nishino, Yoshikazu ; You, San Lin ; Koh, Woon Puay ; Park, Sue K. ; Shen, Chen Yang ; Thornquist, Mark ; Kang, Daehee ; Rolland, Betsy ; Feng, Ziding ; Zheng, Wei ; Potter, John D. / Body mass index and diabetes in Asia : A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium. In: PLoS One. 2011 ; Vol. 6, No. 6.
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abstract = "Background: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. Methods and Findings: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3{\%} in the overall population, ranging from 0.5{\%} to 8.2{\%} across participating cohorts. Using the category 22.5-24.9 Kg/m 2 as reference, the OR for diabetes spanned from 0.58 (95{\%} confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m 2 to 2.23 (95{\%} CI 1.86, 2.67) for BMI higher than 34.9 kg/m 2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. Conclusions: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.",
author = "Paolo Boffetta and Dale McLerran and Yu Chen and Manami Inoue and Rashmi Sinha and Jiang He and Gupta, {Prakash Chandra} and Shoichiro Tsugane and Fujiko Irie and Akiko Tamakoshi and Gao, {Yu Tang} and Shu, {Xiao Ou} and Renwei Wang and Ichiro Tsuji and Shinichi Kuriyama and Keitaro Matsuo and Hiroshi Satoh and Chen, {Chien Jen} and Yuan, {Jian Min} and Yoo, {Keun Young} and Habibul Ahsan and Pan, {Wen Harn} and Dongfeng Gu and Pednekar, {Mangesh Suryakant} and Shizuka Sasazuki and Toshimi Sairenchi and Gong Yang and Xiang, {Yong Bing} and Masato Nagai and Hideo Tanaka and Yoshikazu Nishino and You, {San Lin} and Koh, {Woon Puay} and Park, {Sue K.} and Shen, {Chen Yang} and Mark Thornquist and Daehee Kang and Betsy Rolland and Ziding Feng and Wei Zheng and Potter, {John D.}",
year = "2011",
doi = "10.1371/journal.pone.0019930",
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TY - JOUR

T1 - Body mass index and diabetes in Asia

T2 - A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium

AU - Boffetta, Paolo

AU - McLerran, Dale

AU - Chen, Yu

AU - Inoue, Manami

AU - Sinha, Rashmi

AU - He, Jiang

AU - Gupta, Prakash Chandra

AU - Tsugane, Shoichiro

AU - Irie, Fujiko

AU - Tamakoshi, Akiko

AU - Gao, Yu Tang

AU - Shu, Xiao Ou

AU - Wang, Renwei

AU - Tsuji, Ichiro

AU - Kuriyama, Shinichi

AU - Matsuo, Keitaro

AU - Satoh, Hiroshi

AU - Chen, Chien Jen

AU - Yuan, Jian Min

AU - Yoo, Keun Young

AU - Ahsan, Habibul

AU - Pan, Wen Harn

AU - Gu, Dongfeng

AU - Pednekar, Mangesh Suryakant

AU - Sasazuki, Shizuka

AU - Sairenchi, Toshimi

AU - Yang, Gong

AU - Xiang, Yong Bing

AU - Nagai, Masato

AU - Tanaka, Hideo

AU - Nishino, Yoshikazu

AU - You, San Lin

AU - Koh, Woon Puay

AU - Park, Sue K.

AU - Shen, Chen Yang

AU - Thornquist, Mark

AU - Kang, Daehee

AU - Rolland, Betsy

AU - Feng, Ziding

AU - Zheng, Wei

AU - Potter, John D.

PY - 2011

Y1 - 2011

N2 - Background: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. Methods and Findings: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 Kg/m 2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m 2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m 2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. Conclusions: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

AB - Background: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. Methods and Findings: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 Kg/m 2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m 2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m 2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. Conclusions: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

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U2 - 10.1371/journal.pone.0019930

DO - 10.1371/journal.pone.0019930

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JO - PLoS One

JF - PLoS One

SN - 1932-6203

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