American Journal of Epidemiology Advance Access originally published online on March 28, 2008
American Journal of Epidemiology 2008 167(11):1365-1374; doi:10.1093/aje/kwn060
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ORIGINAL CONTRIBUTIONS |
Impact of Body Mass Index on Incident Hypertension and Diabetes in Chinese Asians, American Whites, and American Blacks
The People's Republic of China Study and the Atherosclerosis Risk in Communities Study
1 Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, NC
2 Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC
3 Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC
Correspondence to Dr. June Stevens, Department of Nutrition, CB 7461, University of North Carolina, Chapel Hill, NC 27599 (e-mail: June_Stevens{at}unc.edu).
Received for publication September 27, 2007. Accepted for publication February 20, 2008.
Researchers have hypothesized that the impact of body mass index on chronic disease may be greater in Asians than in Whites; however, most studies are cross-sectional and have no White comparison group. The authors compared the associations with body mass index in Chinese Asians (n = 5,980), American Whites (n = 10,776), and American Blacks (n = 3,582) using prospective data from the People's Republic of China Study (1983–1994) and the Atherosclerosis Risk in Communities Study (1987–1998). Slopes of risk differences over body mass index levels were compared among the three ethnic groups in adjusted analyses. The authors found larger associations with body mass index in Chinese Asians compared with American Whites and Blacks for hypertension (p < 0.05). The increase in the incidence of hypertension associated with a one-unit increase in body mass index over approximately 8 years of follow-up was 2.5, 1.7, and 1.8 percentage points for Chinese Asians, American Whites, and American Blacks, respectively. For diabetes, the estimates were 1.7, 1.1, and 1.6 percentage points for the same groups— higher in Chinese Asians than in American Whites (p < 0.05) but similar between Chinese Asians and American Blacks. Given the ethnic differences in associations, the results support advocacy of public health and medical actions toward obesity prevention and treatment in China.
Asian continental ancestry group; body mass index; diabetes mellitus; ethnic groups; hypertension
Abbreviations: ARIC, Atherosclerosis Risk in Communities; PRC, People's Republic of China
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