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. 2011;6(10):e26464.
doi: 10.1371/journal.pone.0026464. Epub 2011 Oct 19.

Defining obesity cut-off points for migrant South Asians

Laura J Gray  1 , Thomas Yates, Melanie J Davies, Emer Brady, David R Webb, Naveed Sattar, Kamlesh Khunti
Affiliations

Defining obesity cut-off points for migrant South Asians

Laura J Gray et al. PLoS One. 2011.

Abstract

Background: Body mass index (BMI) and waist circumference (WC) are used to define cardiovascular and type 2 diabetes risk. We aimed to derive appropriate BMI and WC obesity cut-off points in a migrant South Asian population.

Methods: 4688 White Europeans and 1333 South Asians resident in the UK aged 40-75 years inclusive were screened for type 2 diabetes. Principal components analysis was used to derive a glycaemia, lipid, and a blood pressure factor. Regression models for each factor, adjusted for age and stratified by sex, were used to identify BMI and WC cut-off points in South Asians that correspond to those defined for White Europeans.

Findings: For South Asian males, derived BMI obesity cut-off points equivalent to 30.0 kg/m(2) in White Europeans were 22.6 kg/m(2) (95% Confidence Interval (95% CI) 20.7 kg/m(2) to 24.5 kg/m(2)) for the glycaemia factor, 26.0 kg/m(2) (95% CI 24.7 kg/m(2) to 27.3 kg/m(2)) for the lipid factor, and 28.4 kg/m(2) (95% CI 26.5 kg/m(2) to 30.4 kg/m(2)) for the blood pressure factor. For WC, derived cut-off points for South Asian males equivalent to 102 cm in White Europeans were 83.8 cm (95% CI 79.3 cm to 88.2 cm) for the glycaemia factor, 91.4 cm (95% CI 86.9 cm to 95.8 cm) for the lipid factor, and 99.3 cm (95% CI 93.3 cm to 105.2 cm) for the blood pressure factor. Lower ethnicity cut-off points were seen for females for both BMI and WC.

Conclusions: Substantially lower obesity cut-off points are needed in South Asians to detect an equivalent level of dysglycemia and dyslipidemia as observed in White Europeans. South Asian ethnicity could be considered as a similar level of risk as obesity (in White Europeans) for the development of type 2 diabetes.

Trial registration: ClinicalTrials.gov NCT00318032.

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Conflict of interest statement

Competing Interests: The authors have read the journal's policy and have the following conflicts: KK is a Member of the South Asian Health Foundation. This does not alter the authors' adherence to all PLoS ONE polices on sharing data and materials.

Figures

Figure 1
Figure 1. Relationship between glycaemia factor and BMI among White European and South Asian males.
The glycaemia factor is the single summary variable derived from the principal components analysis using fasting glucose, 2 hour glucose and HbA1c.
Figure 2
Figure 2. Relationship between glycaemia factor and BMI among White European and South Asian females.
The glycaemia factor is the single summary variable derived from the principal components analysis using fasting glucose, 2 hour glucose and HbA1c.
See this image and copyright information in PMC

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