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Secular and Race/Ethnic Trends in Glycemic Outcomes by BMI in US Adults: The Role of Waist Circumference

Citation

Albrecht, Sandra S.; Mayer-Davis, Elizabeth J.; & Popkin, Barry M. (2017). Secular and Race/Ethnic Trends in Glycemic Outcomes by BMI in US Adults: The Role of Waist Circumference. Diabetes/Metabolism Research and Reviews, 33(5), e2889.

Abstract

Background: For the same BMI level, waist circumference (WC) is higher in more recent years. How this impacts diabetes and pre-diabetes prevalence in the US and for different race/ethnic groups is unknown. We examined prevalence differences diabetes and pre-diabetes by BMI over time, investigated whether estimates were attenuated after adjusting for WC, and evaluated implications of these patterns on race/ethnic disparities in glycemic outcomes.
Methods: Data came from 12,614 participants aged 20-74 years from the National Health and Nutrition Examination Surveys (1988-1994; 2007-2012). We estimated prevalence differences in diabetes and pre-diabetes by BMI over time in multivariable models. Relevant interactions evaluated race/ethnic differences.
Results: Among normal, overweight, and class I obese individuals, there were no significant differences in diabetes prevalence over time. However among individuals with class II/III obesity, diabetes prevalence rose 7.6 percentage points in 2007-2012 vs. 1988-1994. This estimate was partly attenuated after adjustment for mean WC, but not mean BMI. For pre-diabetes, prevalence was 10-13 percentage points higher over time at lower BMI values, with minimal attenuation after adjustment for WC. All patterns held within race/ethnic groups. Diabetes disparities among blacks and Mexican-Americans relative to whites remained in both time periods, regardless of BMI, and persisted after adjustment for WC.
Conclusions: Diabetes prevalence rose over time among individuals with class II/III obesity, and may be partly due to increasing WC. Anthropometric measures did not appear to account for temporal increases in pre-diabetes, nor did they attenuate race/ethnic disparities in diabetes. Reasons underlying these trends require further investigation.

URL

http://dx.doi.org/10.1002/dmrr.2889

Reference Type

Journal Article

Year Published

2017

Journal Title

Diabetes/Metabolism Research and Reviews

Author(s)

Albrecht, Sandra S.
Mayer-Davis, Elizabeth J.
Popkin, Barry M.