Abstract 4087: Acculturation is Associated with Diabetes Prevalence in the Multiethnic Study of Atherosclerosis
Background: The prevalence of diabetes (DM) is increasing in Hispanic and Chinese Americans-groups largely comprised of immigrants. Acculturation and subsequent behavior changes may contribute to the development of DM in these groups.
Objective: To study the association between acculturation and DM. We hypothesized a positive association between greater acculturation and DM prevalence.
Methods: We analyzed cross-sectional data on 1252 Hispanic and 737 Chinese participants in MESA, a six-center cohort study of the determinants of subclinical cardiovascular disease (CVD) in persons aged 45– 84 years with no history of clinical CVD. For this analysis, participants were excluded if they were missing data on nativity or years in the US. Whites and Blacks were excluded because very few were immigrants. DM was defined as fasting plasma glucose ≥126 mg/dl and/or use of anti-DM medications. An acculturation score was calculated using nativity, years in US, and language. The score ranged from 0–5; 0=least acculturated and 5=most acculturated (e.g., US-born who speaks only English at home was assigned a 5; foreign-born who is in US for < 10 years and speaks no English at home was assigned a 0).
Results: DM prevalence increased as acculturation score increased P-trend=0.016; Table⇓ column 3). Lower acculturation was associated with lower odds of diabetes in Hispanics, after adjustment for age, sex, income and education (P-trend=0.015; Table⇓ column 5), but not in Chinese (Table⇓ column 7). Adjustment for BMI weakened the association between acculturation and DM in Hispanics, suggesting that BMI partly mediates the association.
Conclusion: Lower acculturation is associated with lower odds of DM prevalence in Hispanics. Acculturation should be considered when studying risk factors for diabetes, particularly in Hispanics.