Abstract P263: Central Obesity and the Emerging Epidemic of Type 2 Diabetes in Saudi Arabia
Introduction: Obesity is considered to be one of the most significant emerging public health problems in Saudi Arabia. Saudi Arabia is in the top ten countries as to the prevalence of obesity (35.6%) and diabetes (31.6%). However, the associations between different obesity measures and type 2 diabetes mellitus (T2DM) have not been extensively investigated within the Saudi context.
Objective: We sought to examine the cross-sectional associations between measures of body weight and body fat distribution such as body mass index (BMI), waist circumference (WC) and T2DM prevalence in Saudi adults.
Methods: This study was based on 2355 Saudi adults (≥18 years), part of a larger sample of 14,060 participants randomly selected from a roster of 150 primary health care centers (PHCC’s) of Riyadh city, Saudi Arabia. For each PHCC, a physician invited participants from randomly selected households (alternate houses). The number of subjects sampled from each PHCC was dependent on the total population assigned to the respective PHCC.
Physicians confirmed diabetes diagnosis by either following World Health Organization proposed cut-off values (fasting plasma glucose levels ≥ 7.0 mmol/L) and/or self-report of anti-diabetes medications.
For the overall sample and for men and women separately, logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI) of T2DM prevalence across BMI groups and WC tertiles. The reference category was the lowest. Covariates included: age, sex, marital status, education level, family history of diabetes, physical activity, caloric intake, and history of gestational diabetes (GDM) in females.
Results: The overall prevalence of T2DM was 29.3% (25.4% in females vs. 32.9% in males). Obese females (BMI ≥ 30 kg/m2) had an OR of 3.39 (95% CI, 1.5-7.6, p = 0.001) for diagnosed T2DM, whilst obese males (BMI ≥ 30 kg/m2) had a borderline association with T2DM (OR 1.41, 95% CI, 0.8-2.2, p = 0.077).
Higher values of WC were associated with T2DM in both females and males. However, males with a higher WC (≥ 104 cm) had a significant association with T2DM even after multivariate adjustment (OR 1.99, 95% CI, 1.2-3.1, p = 0.006).
In the overall sample, a direct and statistically significant (p = 0.014) association between the age-sex adjusted OR for T2DM and WC persisted within each group of BMI. However, this association was not significant (p = 0.572) between BMI and T2DM across tertiles of WC.
Conclusion: Results suggest that measures of central adiposity, indicated by WC, are associated with diabetes, independently of BMI, whereas the associations of BMI with diabetes is greatly attenuated after accounting for body fat distribution.
Author Disclosures: L. Al Khudairy: None. K. Rees: None. S. Kumar: None. N. Al-Daghri: None. O. Al Attas: None. M. Al Okail: None. K. Al Kharfy: None. S. Stranges: None.
- © 2015 by American Heart Association, Inc.