Abstract
Background/Objectives:
Obesity and diabetes rates are high in Native Hawaiians (NHs) who commonly have mixed ancestries. People of Asian ancestry experience a high risk of type 2 diabetes despite the relatively low body weight. We evaluated the impact of ethnic admixture on diabetes risk among NHs in the Multiethnic Cohort (MEC).
Subjects/Methods:
On the basis of self-reports, 11 521 eligible men and women were categorized into NH/white, NH/other, NH alone, NH/Asian and the most common three ancestry admixture, NH/Chinese/white. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with the NH/white category as the reference group; covariates included known confounders—that is, body mass index (BMI), dietary and other lifestyle factors.
Results:
The NH alone category had the highest proportion of overweight and obese individuals and the NH/Asian category the lowest proportion. During 12 years of follow-up after cohort entry at 56 years, 2072 incident cases were ascertained through questionnaires and health plan linkages. All NH categories had higher HRs than the NH/white category before and after adjustment for BMI. In the fully adjusted models, the NH/Asian category showed the highest risk (HR=1.45; 95% CI: 1.27–1.65), followed by NH/other (HR=1.20; 95% CI: 1.03–1.39), NH/Chinese/white (HR=1.19; 95% CI: 1.04–1.37) and NH alone (HR=1.19; 95% CI: 1.03–1.37). The elevated risk by Asian admixture was more pronounced in normal weight than overweight/obese individuals.
Conclusions:
These findings indicate that Asian admixture in NHs is associated with a higher risk for type 2 diabetes independent of known risk factors and suggest a role for ethnicity-related genetic factors in the development of this disease.
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Acknowledgements
The Multiethnic Cohort Study has been supported by US Public Health Service (National Institutes of Health) grants R37CA54281 and UM1CA164973 and the diabetes project by R21DK073816. MKM was supported in part by NIH funding P20 MD 000173.
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Maskarinec, G., Morimoto, Y., Jacobs, S. et al. Ethnic admixture affects diabetes risk in native Hawaiians: the Multiethnic Cohort. Eur J Clin Nutr 70, 1022–1027 (2016). https://doi.org/10.1038/ejcn.2016.32
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DOI: https://doi.org/10.1038/ejcn.2016.32
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