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Body mass index and type 2 diabetes in Thai adults: defining risk thresholds and population impacts.

Papier, Keren; D'Este, Catherine; Bain, Christopher; Banwell, Cathy; Seubsman, Sam-ang; Sleigh, Adrian; Jordan, Susan

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Background Body mass index (BMI) cut-off values (>25 and >30) that predict diabetes risk have been well validated in Caucasian populations but less so in Asian populations. We aimed to determine the BMI threshold associated with increased type 2 diabetes (T2DM) risk and to calculate the proportion of T2DM cases attributable to overweight and obesity in the Thai population. Methods Participants were those from the Thai Cohort Study who were diabetes-free in 2005 and were followed-up in...[Show more]

dc.contributor.authorPapier, Keren
dc.contributor.authorD'Este, Catherine
dc.contributor.authorBain, Christopher
dc.contributor.authorBanwell, Cathy
dc.contributor.authorSeubsman, Sam-ang
dc.contributor.authorSleigh, Adrian
dc.contributor.authorJordan, Susan
dc.date.accessioned2021-05-13T23:35:56Z
dc.date.available2021-05-13T23:35:56Z
dc.identifier.issn1471-2458
dc.identifier.urihttp://hdl.handle.net/1885/233036
dc.description.abstractBackground Body mass index (BMI) cut-off values (>25 and >30) that predict diabetes risk have been well validated in Caucasian populations but less so in Asian populations. We aimed to determine the BMI threshold associated with increased type 2 diabetes (T2DM) risk and to calculate the proportion of T2DM cases attributable to overweight and obesity in the Thai population. Methods Participants were those from the Thai Cohort Study who were diabetes-free in 2005 and were followed-up in 2009 and 2013 (n = 39,021). We used multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the BMI-T2DM association. We modelled non-linear associations using restricted cubic splines. We estimated population attributable fractions (PAF) and the number of T2DM incident cases attributed to overweight and obesity. We also calculated the impact of reducing the prevalence of overweight and obesity on T2DM incidence in the Thai population. Results Non-linear modelling indicated that the points of inflection where the BMI-T2DM association became statistically significant compared to a reference of 20.00 kg/m2 were 21.60 (OR = 1.27, 95% CI 1.00–1.61) and 20.03 (OR = 1.02, 95% CI 1.02–1.03) for men and women, respectively. Approximately two-thirds of T2DM cases in Thai adults could be attributed to overweight and obesity. Annually, if prevalent obesity was 5% lower, ~13,000 cases of T2DM might be prevented in the Thai population. Conclusions A BMI cut-point of 22 kg/m2, one point lower than the current 23 kg/m2, would be justified for defining T2DM risk in Thai adults. Lowering obesity prevalence would greatly reduce T2DM incidence.
dc.description.sponsorshipThis study was supported by the International Collaborative Research Grants Scheme with joint grants from the Wellcome Trust UK (GR071587MA). SJ is supported by a Career Development Fellowship from the NHMRC. KP has an Australian Postgraduate Award from the Australian National University.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central Ltd.
dc.rights© The Author(s). 2017
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Public Health
dc.source.urihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-017-4708-7
dc.subjectBody mass index,
dc.subjectDiabetes
dc.subjectCut-points
dc.subjectPopulation attributable fraction
dc.subjectAsian cohort
dc.titleBody mass index and type 2 diabetes in Thai adults: defining risk thresholds and population impacts.
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume17
dc.date.issued2017
local.identifier.absfor111700 - PUBLIC HEALTH AND HEALTH SERVICES
local.identifier.ariespublicationu5684624xPUB211
local.publisher.urlhttps://bmcpublichealth.biomedcentral.com
local.type.statusPublished Version
local.contributor.affiliationPapier, Keren, College of Health and Medicine, ANU
local.contributor.affiliationD'Este, Catherine, College of Health and Medicine, ANU
local.contributor.affiliationBain, Christopher, College of Health and Medicine, ANU
local.contributor.affiliationBanwell, Cathy, College of Health and Medicine, ANU
local.contributor.affiliationSeubsman, Sam-ang, Sukhothai Thammathirat Open University
local.contributor.affiliationSleigh, Adrian, College of Health and Medicine, ANU
local.contributor.affiliationJordan, Susan, QIMR Berghofer Medical Research Institute
dc.relationhttp://purl.org/au-research/grants/nhmrc/268055
dc.relationhttp://purl.org/au-research/grants/nhmrc/585426
local.bibliographicCitation.issue707
local.identifier.doi10.1186/s12889-017-4708-7
dc.date.updated2020-11-23T10:15:50Z
local.identifier.scopusID2-s2.0-85029536082
dcterms.accessRightsopen access
dc.provenanceThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights.licenseCreative Commons Attribution licence
CollectionsANU Research Publications

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