Secondary analyses of global datasets: do obesity and physical activity explain variation in diabetes risk across populations?
Journal
International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
21
05
2020
accepted:
20
01
2021
revised:
09
12
2020
pubmed:
13
2
2021
medline:
24
12
2021
entrez:
12
2
2021
Statut:
ppublish
Résumé
Type 2 diabetes rates vary significantly across geographic regions. These differences are sometimes assumed to be entirely driven by differential distribution of environmental triggers, including obesity and insufficient physical activity (IPA). In this review, we discuss data which conflicts with this supposition. We carried out a secondary analysis of publicly available data to unravel the relative contribution of obesity and IPA towards diabetes risk across different populations. We used sex-specific, age-standardized estimates from Non-Communicable Disease Risk Factor Collaboration (NCD-RisC) on diabetes (1980-2014) and obesity (1975-2016) rates, in 200 countries, and from WHO on IPA rates in 168 countries in the year 2016. NCD-RisC and WHO organized countries into nine super-regions. All analyses were region- and sex-specific. Although obesity has been increasing since 1975 in every part of the world, this was not reflected in a proportional increase in diabetes rates in several regions, including Central and Eastern Europe, and High-income western countries region. Similarly, the association of physical inactivity with diabetes is not homogeneous across regions. Countries from different regions across the world could have very similar rates of diabetes, despite falling on opposite ends of IPA rate spectrum. The combined effect of obesity and IPA on diabetes risk was analyzed at the worldwide and country level. The overall findings highlighted the larger impact of obesity on disease risk; low IPA rates do not seem to be protective of diabetes, when obesity rates are high. Despite that, some countries deviate from this overall observation. Sex differences were observed across all our analyses. Overall, data presented in this review indicate that different populations, while experiencing similar environmental shifts, are apparently differentially subject to diabetes risk. Sex-related differences observed suggest that males and females are either subject to different risk factor exposures or have different responses to them.
Identifiants
pubmed: 33574565
doi: 10.1038/s41366-021-00764-y
pii: 10.1038/s41366-021-00764-y
pmc: PMC8081659
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
944-956Subventions
Organisme : Medical Research Council
ID : MR/M013138/1
Pays : United Kingdom
Organisme : Biotechnology and Biological Sciences Research Council
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M013138/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S019669/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S03658X/1
Pays : United Kingdom
Références
King H, Rewers M. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care. 1993;16:157–77.
pubmed: 8123057
doi: 10.2337/diacare.16.1.157
Joslin EP. The prevention of diabetes mellitus. J of the Am Med Assoc. 1921;76:79–84.
doi: 10.1001/jama.1921.02630020001001
Colditz GA, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al. Weight as a risk factor for clinical diabetes in females. Am J Epidemiol. 1990;132:501–13.
pubmed: 2389754
doi: 10.1093/oxfordjournals.aje.a115686
Cassano PA, Rosner B, Vokonas PS, Weiss ST. Obesity and body fat distribution in relation to the incidence of non-insulin-dependent diabetes mellitus. A prospective cohort study ofmales in the normative aging study. Am J Epidemiol. 1992;136:1474–86.
pubmed: 1288277
doi: 10.1093/oxfordjournals.aje.a116468
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in males. Diabetes Care. 1994;17:961–9.
pubmed: 7988316
doi: 10.2337/diacare.17.9.961
Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in females. Ann Intern Med. 1995;122:481–6.
pubmed: 7872581
doi: 10.7326/0003-4819-122-7-199504010-00001
Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med. 1991;325:147–52.
pubmed: 2052059
doi: 10.1056/NEJM199107183250302
Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in females. Lancet. 1991;338:774–8.
pubmed: 1681160
doi: 10.1016/0140-6736(91)90664-B
Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA. 1992;268:63–7.
pubmed: 1608115
doi: 10.1001/jama.1992.03490010065031
Burchfiel CM, Sharp DS, Curb JD, Rodriguez BL, Hwang LJ, Marcus EB, et al. Physical activity and incidence of diabetes: the Honolulu Heart Program. Am J Epidemiol. 1995;141:360–8.
pubmed: 7840114
doi: 10.1093/aje/141.4.360
Perry IJ, Wannamethee SG, Walker MK, Thomson AG, Whincup PH, Shaper AG. Prospective study of risk factors for development of non-insulin dependent diabetes in middle aged Britishmales. BMJ. 1995;310:560–4.
pubmed: 7888929
pmcid: 2548938
doi: 10.1136/bmj.310.6979.560
Lynch J, Helmrich SP, Lakka TA, Kaplan GA, Cohen RD, Salonen R, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-agedmales. Arch Intern Med. 1996;156:1307–14.
pubmed: 8651839
doi: 10.1001/archinte.1996.00440110073010
Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willett WC, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in females: a prospective study. Jama. 1999;282:1433–9.
pubmed: 10535433
doi: 10.1001/jama.282.15.1433
Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in females. Jama. 2003;289:1785–91.
pubmed: 12684356
doi: 10.1001/jama.289.14.1785
Hu G, Qiao Q, Silventoinen K, Eriksson JG, Jousilahti P, Lindström J, et al. Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnishmales and females. Diabetologia. 2003;46:322–9.
pubmed: 12687329
doi: 10.1007/s00125-003-1031-x
International Diabetes Federation. IDF Diabetes Atlas. 9th edn. Brussels, Belgium: International Diabetes Federation; 2017.
Abate N, Chandalia M. The impact of ethnicity on type 2 diabetes. J Diabetes Complications. 2003;17:39–58.
pubmed: 12505756
doi: 10.1016/S1056-8727(02)00190-3
Dagogo-Jack S. Ethnic disparities in type 2 diabetes: pathophysiology and implications for prevention and management. J Natl Med Assoc. 2003;95:774.
pubmed: 14527045
pmcid: 2594463
Abate N, Chandalia M. Ethnicity and type 2 diabetes: focus on Asian Indians. J Diabetes Complications. 2001;15:320–7.
pubmed: 11711326
doi: 10.1016/S1056-8727(01)00161-1
Banerji MA, Faridi N, Atluri R, Chaiken RL, Lebovitz HE. Body composition, visceral fat, leptin, and insulin resistance in Asian Indianmales. The. Journal of clinical endocrinology and metabolism. 1999;84:137–44.
pubmed: 9920074
Nakagami T, Qiao Q, Carstensen B, Nhr-Hansen C, Hu G, Tuomilehto J, et al. Age, body mass index and Type 2 diabetes-associations modified by ethnicity. Diabetologia. 2003;46:1063–70.
pubmed: 12827246
doi: 10.1007/s00125-003-1158-9
Després JP, Nadeau A, Tremblay A, Ferland M, Moorjani S, Lupien PJ, et al. Role of deep abdominal fat in the association between regional adipose tissue distribution and glucose tolerance in obese females. Diabetes. 1989;38:304–9.
pubmed: 2645187
doi: 10.2337/diab.38.3.304
Abate N, Garg A, Peshock RM, Stray-Gundersen J, Grundy SM. Relationships of generalized and regional adiposity to insulin sensitivity in males. J Clin Invest. 1995;96:88–98.
pubmed: 7615840
pmcid: 185176
doi: 10.1172/JCI118083
Després JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasma lipoproteins, and cardiovascular disease. Arteriosclerosis. 1990;10:497–511.
pubmed: 2196040
doi: 10.1161/01.ATV.10.4.497
Després JP. Is visceral obesity the cause of the metabolic syndrome? Ann Med. 2006;38:52–63.
pubmed: 16448989
doi: 10.1080/07853890500383895
Golan R, Shelef I, Rudich A, Gepner Y, Shemesh E, Chassidim Y, et al. Abdominal superficial subcutaneous fat: a putative distinct protective fat subdepot in type 2 diabetes. Diabetes Care. 2012;35:640–7.
pubmed: 22344612
pmcid: 3322677
doi: 10.2337/dc11-1583
Shai I, Jiang R, Manson JE, Stampfer MJ, Willett WC, Colditz GA, et al. Ethnicity, obesity, and risk of type 2 diabetes in females: a 20-year follow-up study. Diabetes Care. 2006;29:1585–90.
pubmed: 16801583
doi: 10.2337/dc06-0057
Ramachandran A, Snehalatha C, Viswanathan V, Viswanathan M, Haffner SM. Risk of noninsulin dependent diabetes mellitus conferred by obesity and central adiposity in different ethnic groups: a comparative analysis between Asian Indians, Mexican Americans and Whites. Diabetes Res Clin Pract. 1997;36:121–5.
pubmed: 9229196
doi: 10.1016/S0168-8227(97)00040-5
Ujcic-Voortman JK, Schram MT, Jacobs-van der Bruggen MA, Verhoeff AP, Baan CA. Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health. 2009;19:511–5.
pubmed: 19587231
doi: 10.1093/eurpub/ckp096
Admiraal WM, van Valkengoed IG, LdM JS, Stronks K, Hoekstra JB, Holleman F. The association of physical inactivity with Type 2 diabetes among different ethnic groups. Diabet Med. 2011;28:668–72.
pubmed: 21569087
doi: 10.1111/j.1464-5491.2011.03248.x
Jenum AK, Holme I, Graff-Iversen S, Birkeland KI. Ethnicity and sex are strong determinants of diabetes in an urban Western society: implications for prevention. Diabetologia. 2005;48:435–9.
pubmed: 15729578
doi: 10.1007/s00125-005-1668-8
Joseph JJ, Echouffo-Tcheugui JB, Golden SH, Chen H, Jenny NS, Carnethon MR, et al. Physical activity, sedentary behaviors and the incidence of type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis (MESA). BMJ Open Diabetes Res Care. 2016;4:e000185.
pubmed: 27403323
pmcid: 4932325
doi: 10.1136/bmjdrc-2015-000185
NCD Risk Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016;387:1513–30.
NCD Risk Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390:2627–42.
Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health. 2018;6:e1077–e86.
pubmed: 30193830
doi: 10.1016/S2214-109X(18)30357-7
NCD Risk Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016;387:1377–96.
NCD Risk Collaboration (NCD-RisC). Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants. Lancet. 2017;389:37–55.
Finucane MM, Paciorek CJ, Danaei G, Ezzati M. Bayesian estimation of population-level trends in measures of health status. Statistical Science. 2014;29:18–25.
doi: 10.1214/13-STS427
WHO. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010.
Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Jama. 1995;273:402–7.
pubmed: 7823386
doi: 10.1001/jama.1995.03520290054029
Norgan NG. Population differences in body composition in relation to the body mass index. Eur J Clin Nutr. 1994;48:S10–25. discussion S6-7
pubmed: 7843146
Deurenberg P, Deurenberg Yap M, Wang J, Lin FP, Schmidt G. The impact of body build on the relationship between body mass index and percent body fat. Int J Obes Relat Metab Disord. 1999;23:537–42.
pubmed: 10375058
doi: 10.1038/sj.ijo.0800868
McKeigue PM, Pierpoint T, Ferrie JE, Marmot MG. Relationship of glucose intolerance and hyperinsulinaemia to body fat pattern in south Asians and Europeans. Diabetologia. 1992;35:785–91.
pubmed: 1511807
doi: 10.1007/BF00429101
Karter AJ, Mayer-Davis EJ, Selby JV, D’Agostino RB Jr, Haffner SM, Sholinsky P, et al. Insulin sensitivity and abdominal obesity in African-American, Hispanic, and non-Hispanic whitemales and females. The insulin resistance and atherosclerosis study. Diabetes. 1996;45:1547–55.
pubmed: 8866560
doi: 10.2337/diab.45.11.1547
Wang J, Thornton JC, Russell M, Burastero S, Heymsfield S, Pierson RN Jr. Asians have lower body mass index (BMI) but higher percent body fat than do whites: comparisons of anthropometric measurements. Am J Clin Nutr. 1994;60:23–8.
pubmed: 8017333
doi: 10.1093/ajcn/60.1.23
Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differences in risk, pathophysiology and complications of type 2 diabetes mellitus. Endocr Rev. 2016;37:278–316.
pubmed: 27159875
pmcid: 4890267
doi: 10.1210/er.2015-1137
Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
pubmed: 11832527
doi: 10.1056/NEJMoa012512
Gregg EW, Albright AL. The public health response to diabetes–two steps forward, one step back. Jama. 2009;301:1596–8.
pubmed: 19366782
doi: 10.1001/jama.2009.519
Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–50.
doi: 10.1056/NEJM200105033441801
Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The indian diabetes prevention programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49:289–97.
pubmed: 16391903
doi: 10.1007/s00125-005-0097-z
Saaristo T, Moilanen L, Korpi-Hyövälti E, Vanhala M, Saltevo J, Niskanen L, et al. Lifestyle intervention for prevention of type 2 diabetes in primary health care: one-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D). Diabetes Care. 2010;33:2146–51.
pubmed: 20664020
pmcid: 2945150
doi: 10.2337/dc10-0410