Body mass index and diabetes in Asia: A cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium

Paolo Boffetta, Dale McLerran, Yu Chen, Manami Inoue, Rashmi Sinha, Jiang He, Prakash Chandra Gupta, Shoichiro Tsugane, Fujiko Irie, Akiko Tamakoshi, Yu Tang Gao, Xiao Ou Shu, Renwei Wang, Ichiro Tsuji, Shinichi Kuriyama, Keitaro Matsuo, Hiroshi Satoh, Chien Jen Chen, Jian Min Yuan, Keun Young YooHabibul Ahsan, Wen Harn Pan, Dongfeng Gu, Mangesh Suryakant Pednekar, Shizuka Sasazuki, Toshimi Sairenchi, Gong Yang, Yong Bing Xiang, Masato Nagai, Hideo Tanaka, Yoshikazu Nishino, San Lin You, Woon Puay Koh, Sue K. Park, Chen Yang Shen, Mark Thornquist, Daehee Kang, Betsy Rolland, Ziding Feng, Wei Zheng, John D. Potter

Research output: Contribution to journalArticlepeer-review


Background: The occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived populations, overweight and obesity are established causes of diabetes. The shape of the association of overweight and obesity with diabetes risk and its overall impact have not been adequately studied in Asia. Methods and Findings: A pooled cross-sectional analysis was conducted to evaluate the association between baseline body mass index (BMI, measured as weight in kg divided by the square of height in m) and self-reported diabetes status in over 900,000 individuals recruited in 18 cohorts from Bangladesh, China, India, Japan, Korea, Singapore and Taiwan. Logistic regression models were fitted to calculate cohort-specific odds ratios (OR) of diabetes for categories of increasing BMI, after adjustment for potential confounding factors. OR were pooled across cohorts using a random-effects meta-analysis. The sex- and age-adjusted prevalence of diabetes was 4.3% in the overall population, ranging from 0.5% to 8.2% across participating cohorts. Using the category 22.5-24.9 Kg/m 2 as reference, the OR for diabetes spanned from 0.58 (95% confidence interval [CI] 0.31, 0.76) for BMI lower than 15.0 kg/m 2 to 2.23 (95% CI 1.86, 2.67) for BMI higher than 34.9 kg/m 2. The positive association between BMI and diabetes prevalence was present in all cohorts and in all subgroups of the study population, although the association was stronger in individuals below age 50 at baseline (p-value of interaction<0.001), in cohorts from India and Bangladesh (p<0.001), in individuals with low education (p-value 0.02), and in smokers (p-value 0.03); no differences were observed by gender, urban residence, or alcohol drinking. Conclusions: This study estimated the shape and the strength of the association between BMI and prevalence of diabetes in Asian populations and identified patterns of the association by age, country, and other risk factors for diabetes.

Original languageEnglish (US)
Article numbere19930
JournalPloS one
Issue number6
StatePublished - 2011

ASJC Scopus subject areas

  • General


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