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Epidemiology

Ethnic admixture affects diabetes risk in native Hawaiians: the Multiethnic Cohort

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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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References

  1. Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002; 288: 1723–1727.

    Article  Google Scholar 

  2. International Diabetes Federation IDF Diabetes Atlas (Sixth Edition). 2014. IDF: Bruxelles, Belgium, 2015. Available at www.idf.org/diabetesatlas.

  3. Karter AJ, Schillinger D, Adams AS, Moffet HH, Liu J, Adler NE et al. Elevated rates of diabetes in Pacific Islanders and Asian subgroups: the Diabetes Study of Northern California (DISTANCE). Diabetes Care 2013; 36: 574–579.

    Article  Google Scholar 

  4. Maskarinec G, Takata Y, Pagano I, Carlin L, Goodman MT, Le ML et al. Trends and dietary determinants of overweight and obesity in a multiethnic population. Obesity (Silver Spring) 2006; 14: 717–726.

    Article  Google Scholar 

  5. Lee JW, Brancati FL, Yeh HC . Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997-2008. Diabetes Care 2011; 34: 353–357.

    Article  Google Scholar 

  6. Grandinetti A, Kaholokula JK, Theriault AG, Mor JM, Chang HK, Waslien C . Prevalence of diabetes and glucose intolerance in an ethnically diverse rural community of Hawaii. Ethn Dis 2007; 17: 250–255.

    PubMed  Google Scholar 

  7. Davis J, Busch J, Hammatt Z, Novotny R, Harrigan R, Grandinetti A et al. The relationship between ethnicity and obesity in Asian and Pacific Islander populations: a literature review. Ethn Dis 2004; 14: 111–118.

    Google Scholar 

  8. Maskarinec G, Erber E, Grandinetti A, Verheus M, Oum R, Hopping BN et al. Diabetes incidence based on linkages with health plans: the Multiethnic Cohort. Diabetes 2009; 58: 1732–1738.

    Article  CAS  Google Scholar 

  9. Burchfiel CM, Curb JD, Rodriguez BL, Yano K, Hwang LJ, Fong KO et al. Incidence and predictors of diabetes in Japanese-American men. The Honolulu Heart Program. Ann Epidemiol 1995; 5: 33–43.

    Article  CAS  Google Scholar 

  10. Araneta MR, Wingard DL, Barrett-Connor E . Type 2 diabetes and metabolic syndrome in Filipina-American women: a high-risk nonobese population. Diabetes Care 2002; 25: 494–499.

    Article  Google Scholar 

  11. Staimez LR, Weber MB, Narayan KM, Oza-Frank R . A systematic review of overweight, obesity, and type 2 diabetes among Asian American subgroups. Curr Diabetes Rev 2013; 9: 312–331.

    Article  Google Scholar 

  12. Blaisdell RK . The impact of disease on Hawaii's history. Hawaii Med J 2001; 60: 295–296.

    CAS  PubMed  Google Scholar 

  13. Nordyke EC. . The Peopling of Hawaii. University of Hawaii Press: Honolulu, HI, USA, 1989.

    Google Scholar 

  14. Hawaii Department of Business and Economic Development 2013. State of Hawaii Data Book: A Statistical Abstract, 2014, State of Hawaii, Honolulu, HI, USA. Available at http://dbedt.hawaii.gov/economic/databook/db2013/.

  15. Brown DE, Hampson SE, Dubanoski JP, Murai AS, Hillier TA . Effects of ethnicity and socioeconomic status on body composition in an admixed, multiethnic population in Hawaii. Am J Hum Biol 2009; 21: 383–388.

    Article  Google Scholar 

  16. Albright CL, Steffen AD, Wilkens LR, Henderson BE, Kolonel LN . The prevalence of obesity in ethnic admixture adults. Obesity (Silver Spring) 2008; 16: 1138–1143.

    Article  Google Scholar 

  17. Albright CL, Steffen A, Wilkens LR, Henderson BE, Kolonel LN . Body mass index in monoracial and multiracial adults: results from the multiethnic cohort study. Ethn Dis 2007; 17: 268–273.

    PubMed  Google Scholar 

  18. Maskarinec G, Jacobs S, Morimoto Y, Chock M, Grandinetti A, Kolonel LN . Disparity in diabetes risk across Native Hawaiians and different Asian groups: the multiethnic cohort. Asia Pac J Public Health 2015; 27: 375–384.

    Article  Google Scholar 

  19. Bryc K, Durand EY, Macpherson JM, Reich D, Mountain JL . The genetic ancestry of African Americans, Latinos, and European Americans across the United States. Am J Hum Genet 2015; 96: 37–53.

    Article  CAS  Google Scholar 

  20. Moreno-Estrada A, Gignoux CR, Fernandez-Lopez JC, Zakharia F, Sikora M, Contreras AV et al. Human genetics. The genetics of Mexico recapitulates Native American substructure and affects biomedical traits. Science 2014; 344: 1280–1285.

    Article  CAS  Google Scholar 

  21. Deng L, Hoh BP, Lu D, Saw WY, Twee-Hee OR, Kasturiratne A et al. Dissecting the genetic structure and admixture of four geographical Malay populations. Sci Rep 2015; 5: 14375.

    Article  CAS  Google Scholar 

  22. Kolonel LN, Henderson BE, Hankin JH, Nomura AMY, Wilkens LR, Pike MC et al. A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics. Am J Epidemiol 2000; 151: 346–357.

    Article  CAS  Google Scholar 

  23. Stram DO, Hankin JH, Wilkens LR, Henderson B, Kolonel LN . Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles. Am J Epidemiol 2000; 151: 358–370.

    Article  CAS  Google Scholar 

  24. Steinbrecher A, Morimoto Y, Heak S, Ollberding NJ, Geller KS, Grandinetti A et al. The preventable proportion of type 2 diabetes by ethnicity: the multiethnic cohort. Ann Epidemiol 2011; 21: 526–535.

    Article  Google Scholar 

  25. Doo T, Morimoto Y, Steinbrecher A, Kolonel LN, Maskarinec G . Coffee intake and risk of type 2 diabetes: the Multiethnic Cohort. Public Health Nutr 2014; 17: 1328–1336.

    Article  Google Scholar 

  26. Razak F, Anand SS, Shannon H, Vuksan V, Davis B, Jacobs R et al. Defining obesity cut points in a multiethnic population. Circulation 2007; 115: 2111–2118.

    Article  Google Scholar 

  27. Grandinetti A, Chang HK, Mau MK, Curb JD, Kinney EK, Sagum R et al. Prevalence of glucose intolerance among Native Hawaiians in two rural communities. Native Hawaiian Health Research (NHHR) Project. Diabetes Care 1998; 21: 549–554.

    Article  CAS  Google Scholar 

  28. Grandinetti A, Keawe'aimoku KJ, Chang HK, Chen R, Rodriguez BL, Melish JS et al. Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project. Int J Obes Relat Metab Disord 2002; 26: 778–782.

    Article  CAS  Google Scholar 

  29. Kumar R, Seibold MA, Aldrich MC, Williams LK, Reiner AP, Colangelo L et al. Genetic ancestry in lung-function predictions. N Engl J Med 2010; 363: 321–330.

    Article  CAS  Google Scholar 

  30. Fejerman L, John EM, Huntsman S, Beckman K, Choudhry S, Perez-Stable E et al. Genetic ancestry and risk of breast cancer among U.S. Latinas. Cancer Res 2008; 68: 9723–9728.

    Article  CAS  Google Scholar 

  31. Parra EJ, Hoggart CJ, Bonilla C, Dios S, Norris JM, Marshall JA et al. Relation of type 2 diabetes to individual admixture and candidate gene polymorphisms in the Hispanic American population of San Luis Valley, Colorado. J Med Genet 2004; 41: e116.

    Article  CAS  Google Scholar 

  32. Mau MK, Grandinetti A, Arakaki RF, Chang HK, Kinney EK, Curb JD . The insulin resistance syndrome in native Hawaiians. Native Hawaiian Health Research (NHHR) Project. Diabetes Care 1997; 20: 1376–1380.

    Article  CAS  Google Scholar 

  33. Fujimoto WY, Bergstrom RW, Boyko EJ, Chen K, Kahn SE, Leonetti DL et al. Type 2 diabetes and the metabolic syndrome in Japanese Americans. Diabetes Res Clin Pract 2000; 50 (Suppl 2): S73–S76.

    Article  Google Scholar 

  34. Wilmshurst JM, Hunt TL, Lipo CP, Anderson AJ . High-precision radiocarbon dating shows recent and rapid initial human colonization of East Polynesia. Proc Natl Acad Sci USA 2011; 108: 1815–1820.

    Article  CAS  Google Scholar 

  35. Kim SK, Gignoux CR, Wall JD, Lum-Jones A, Wang H, Haiman CA et al. Population genetic structure and origins of Native Hawaiians in the multiethnic cohort study. PLoS One 2012; 7: e47881.

    Article  CAS  Google Scholar 

  36. Wang H, Haiman CA, Kolonel LN, Henderson BE, Wilkens LR, Le ML et al. Self-reported ethnicity, genetic structure and the impact of population stratification in a multiethnic study. Hum Genet 2010; 128: 165–177.

    Article  Google Scholar 

  37. Molenaar EA, Van Ameijden EJ, Grobbee DE, Numans ME . Comparison of routine care self-reported and biometrical data on hypertension and diabetes: results of the Utrecht Health Project. Eur J Public Health 2007; 17: 199–205.

    Article  Google Scholar 

  38. Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ . Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol 2004; 57: 1096–1103.

    Article  Google Scholar 

  39. Saydah SH, Geiss LS, Tierney E, Benjamin SM, Engelgau M, Brancati F . Review of the performance of methods to identify diabetes cases among vital statistics, administrative, and survey data. Ann Epidemiol 2004; 14: 507–516.

    Article  Google Scholar 

  40. Yeung RO, Zhang Y, Luk A, Yang W, Sobrepena L, Yoon KH et al. Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort. Lancet Diabetes Endocrinol 2014; 2: 935–943.

    Article  CAS  Google Scholar 

  41. Ma RC, Chan JC . Type 2 diabetes in East Asians: similarities and differences with populations in Europe and the United States. Ann NY Acad Sci 2013; 1281: 64–91.

    Article  Google Scholar 

  42. Kodama K, Tojjar D, Yamada S, Toda K, Patel CJ, Butte AJ . Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis. Diabetes Care 2013; 36: 1789–1796.

    Article  CAS  Google Scholar 

  43. Hayashi T, Boyko EJ, McNeely MJ, Leonetti DL, Kahn SE, Fujimoto WY . Visceral adiposity, not abdominal subcutaneous fat area, is associated with an increase in future insulin resistance in Japanese Americans. Diabetes 2008; 57: 1269–1275.

    Article  CAS  Google Scholar 

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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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Authors and Affiliations

  1. University of Hawaii Cancer Center, Honolulu, HI, USA

    G Maskarinec, Y Morimoto & L N Kolonel

  2. German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany

    S Jacobs

  3. Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA

    A Grandinetti

  4. Department of Native Hawaiian Health, JABSOM, University of Hawaii, Honolulu, HI, USA

    M K Mau

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  1. G Maskarinec
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  2. Y Morimoto
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  3. S Jacobs
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  4. A Grandinetti
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  5. M K Mau
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  6. L N Kolonel
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Correspondence to G Maskarinec.

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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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