Evidence of ethnic variations in the relationships between routinely recorded clinical factors and T2D: a systematic review and meta-analysis.

IF 3.8 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

International Journal of Obesity Pub Date : 2025-08-11 DOI:10.1038/s41366-025-01848-9

Binur Orazumbekova, Tooba Hamdani, Sam Hodgson, Miriam Samuel, Daniel Stow, Marie Spreckley, Sarah Finer, Moneeza K Siddiqui, Rohini Mathur

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Abstract

Background: Evidence on ethnic differences in factors associated with type 2 diabetes (T2D) is mixed. We aimed to systematically review evidence on ethnic variations in the relationships between routinely recorded demographic and clinical factors and T2D.

Methods: We searched Medline Complete and Embase for observational studies published between 1990 and 2023 investigating ethnic differences in factors routinely recorded in clinical encounters associated with T2D. We used random and fixed-effects meta-analysis to quantitatively summarise effect sizes across studies where possible. Risk of bias and study quality were assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute tool. PROSPERO registration: CRD42023394148.

Findings: Searches identified 10,694 studies, of which, 54 (n = 10 332,949 individuals) were eligible for inclusion, including 12 suitable for meta-analysis. Included studies reported ethnic differences in age at T2D diagnosis, anthropometric measures, and factors associated with women's health. Compared to individuals of White ethnicity, people of diverse ethnic backgrounds had 2-4-fold higher incidence and prevalence of T2D and younger age of onset. Waist-to-hip ratio (WHR) was a better discriminator of T2D across all ethnic groups compared to body mass index (BMI). While the association between overweight/obese BMI and T2D was strongest for people of White ethnicity (OR 4.85 CI 3.53-6.68) followed by Black (OR 3.27 CI 2.48-4.30) and East Asian ethnicities (OR 3.06 CI 2.29-4.16), the association between WHR and T2D was strongest for people of Black (OR 2.74, CI 2.22-3.39) than for White ethnicities (OR 2.51, CI 2.30-2.74). Included studies highlighted the emerging importance of women-health-associated factors such as index of parity, birth weight and breastfeeding, especially among women of diverse ethnicities.

Conclusion: Ratio measures of central adiposity may better identify T2D in ethnically diverse populations than measures of overall adiposity. Sex-specific factors must be considered when assessing T2D risk.

Funding: Wellcome Trust Grant 218584/Z/19/Z.

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常规记录的临床因素与T2D之间关系的种族差异的证据：系统回顾和荟萃分析。

背景：关于2型糖尿病（T2D）相关因素的种族差异的证据是混合的。我们的目的是系统地回顾常规记录的人口统计学和临床因素与T2D之间关系的种族差异的证据。方法：我们检索Medline Complete和Embase，检索1990年至2023年间发表的观察性研究，调查与T2D相关的临床遭遇常规记录因素的种族差异。我们使用随机和固定效应荟萃分析，在可能的情况下定量总结研究的效应大小。使用纽卡斯尔-渥太华量表和乔安娜布里格斯研究所工具评估偏倚风险和研究质量。普洛斯彼罗注册：CRD42023394148。结果：检索确定了10,694项研究，其中54项（n = 10 332,949人）符合纳入条件，其中12项适合荟萃分析。纳入的研究报告了T2D诊断年龄、人体测量指标和与女性健康相关因素的种族差异。与白人个体相比，不同种族背景的人T2D的发病率和患病率高2-4倍，发病年龄更小。与身体质量指数（BMI）相比，腰臀比（WHR）在所有种族中都是更好的T2D鉴别指标。超重/肥胖BMI与T2D之间的关联在白人中最强（OR 4.85 CI 3.53-6.68），其次是黑人（OR 3.27 CI 2.48-4.30）和东亚种族（OR 3.06 CI 2.29-4.16），黑人WHR与T2D之间的关联最强（OR 2.74, CI 2.22-3.39），而白人种族之间的关联最强（OR 2.51, CI 2.30-2.74）。所包括的研究强调了与妇女健康有关的因素，如胎次指数、出生体重和母乳喂养的重要性，特别是在不同种族的妇女中。结论：中心性肥胖的比值测量比总体肥胖测量能更好地识别不同种族人群的T2D。在评估T2D风险时，必须考虑性别特异性因素。资助：惠康信托基金218584/Z/19/Z。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Obesity 医学-内分泌学与代谢

CiteScore

10.00

自引率

2.00%

发文量

221

审稿时长

3 months

期刊介绍： The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.