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▎The body mass index (BMI) edited by WuXi AppTec's content team is a way to classify individuals overweight.
The cut-off value (BMI≥30 kg/m²) that is currently commonly used to define obesity is based on the study of European and American whites and based on the association between BMI and mortality.
However, more and more evidence shows that the prevalence of type 2 diabetes is higher in Asian populations with BMI lower than this value.
Subsequently, the World Health Organization (WHO) and other institutions suggested that if the BMI of the South Asian and Chinese population exceeds 27.
5 kg/m², life>
However, there are still relatively few research data on BMI and the risk of type 2 diabetes in various ethnic groups.
Recently, a study published in "The Lancet-Diabetes and Endocrinology" found that the BMI cut-off value currently used by WHO and the National Institute of Health and Care (NICE) in the United Kingdom is not applicable through a survey of multi-ethnic populations in the United Kingdom.
For everyone, a lower BMI level in the Chinese population will increase the incidence of type 2 diabetes.
The critical value of "type 2 diabetes risk" found in the study is much lower than the recommendations of WHO and NICE.
Based on these findings, the researchers recommend to revise the cut-off value of BMI for different populations to optimize the prevention, early diagnosis and early management of type 2 diabetes.
Screenshot source: The Lancet Diabetes & Endocrinology The study was led by scholars from Oxford University and included 1,472,819 former and current diabetic-free subjects, aged ≥18 years, and BMI ranging from 15.
0 kg/m² to 50.
0 kg/m².
By.
Among them, whites accounted for 90.
6%, South Asians accounted for 5.
2%, blacks accounted for 3.
4%, Chinese accounted for 0.
7%, and Arabs accounted for 0.
2%.After a median follow-up of 6.
5 years, 97823 cases (6.
6%) were diagnosed with type 2 diabetes.
After adjusting for age and gender, the lower BMI levels of all ethnic groups are as follows, and the risk of developing type 2 diabetes is equivalent to that of whites with a BMI of 30.
0 kg/m² (the cut-off value for obesity): The cut-off value of BMI for the South Asian population is 23.
9 kg/m² The threshold BMI of the black population is 28.
1 kg/m² The threshold BMI of the Chinese population is 26.
9 kg/m² The threshold BMI of the Arab population is 26.
6 kg/m² ▲After adjusting for age and gender, each ethnic population has a different BMI threshold.
The incidence of type 2 diabetes is equivalent when the population BMI is 30.
0 kg/m².
(Screenshot source: Reference [1]) After adjusting for age and gender, the risk of developing type 2 diabetes is equivalent to that of whites with a BMI of 25.
0 kg/m² (the critical value for overweight) when the ethnic groups are at the following BMI levels: South Asia The cut-off value of BMI for the population is 19.
2 kg/m² The cut-off value for the BMI of the black population is 23.
4 kg/m² The cut-off value for the BMI of the Chinese population is 22.
2 kg/m² The cut-off value of BMI for the Arab population is 22.
1 kg/m² ▲After adjusting for age and gender, the ethnic groups are in The different BMI cut-off values are comparable to the incidence of type 2 diabetes in the white population with a BMI of 25.
0 kg/m².
(Screenshot source: Reference [1]) After further adjustment of smoking status and socio-economic status, the threshold of BMI of each ethnic group has not been substantially changed.
Type 2 diabetes can be prevented or delayed by changing diet, increasing physical activity, or using metformin.
Early use of other hypoglycemic treatments can reduce the risk of long-term complications of type 2 diabetes by controlling blood sugar.
The researchers point out that these benefits cannot be fully realized if there is insufficient understanding of obesity and the risks of developing type 2 diabetes.
Compared with the WHO recommendations and the NICE guidelines, the study shows that when the BMI value of African-Caribbean, South Asian, Chinese and Arab people living in the UK is significantly lower than the current defined obesity BMI threshold, the risk of developing type 2 diabetes is comparable to that of the UK The whites are pretty.
The "Lancet-Diabetes and Endocrinology" concurrent review article pointed out that different ethnic groups have different thresholds for obesity-related diabetes risk, and it is not recommended to use a unified BMI threshold to screen and prevent type 2 diabetes.
The study also supports the view that a strict BMI cut-off value should not be used as an independent standard for defining indications for obesity therapy, especially not recommended as an independent standard for indications for weight loss and metabolic surgery.
"It is becoming increasingly clear that whether we regard obesity as a risk factor for future diseases or the disease itself, there are many serious shortcomings in BMI as an indicator of obesity.
If different ethnic groups have different BMI thresholds for the risk of diabetes
If obesity is regarded as a disease, the BMI cut-off value for determining the risk of other obesity-related diseases or death may also be different.
” The review article further proposes that if obesity is regarded as a disease, whether BMI has clinical significance and whether it can be used as a diagnosis basis for the disease.
It is worth thinking about whether or not obesity is defined entirely through BMI. Related reading "The Lancet" sub-issue cover report: Half of the Chinese are fat! With so many "fat" factors, how many have you gotten? Why is it easy to get diabetes when getting fat? "The Lancet" sub-journal research reveals that excess fat affects metabolic disorders.
AHA scientific statement: Obesity has multiple hazards to the cardiovascular system, and waist thickness should also be paid attention to! How to reduce the most useful? JAMA 32 years of big data: 10 years of early diabetes, double the risk of dementia! "Nature" review: More and more young people have type 2 diabetes.
How serious are the consequences? The disease progression and complications are terrible! Source of title map: 123RF References: [1] Caleyachetty, R.
, et al.
, (2021).
Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00088-7[2] Francesco Rubino,David E Cummings.
(2021).
Obesity: what's in a word?.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00122-4[3] Study of 1.
5 million British people shows BMI cut offs for obesity and diabetes risk do not work for non-white populations.
Retrieved 11-MAY-2021, from Note: This article aims to introduce the progress of medical and health research, not a treatment plan recommendation. If you need guidance on the treatment plan, please go to a regular hospital for treatment.
The cut-off value (BMI≥30 kg/m²) that is currently commonly used to define obesity is based on the study of European and American whites and based on the association between BMI and mortality.
However, more and more evidence shows that the prevalence of type 2 diabetes is higher in Asian populations with BMI lower than this value.
Subsequently, the World Health Organization (WHO) and other institutions suggested that if the BMI of the South Asian and Chinese population exceeds 27.
5 kg/m², life>
However, there are still relatively few research data on BMI and the risk of type 2 diabetes in various ethnic groups.
Recently, a study published in "The Lancet-Diabetes and Endocrinology" found that the BMI cut-off value currently used by WHO and the National Institute of Health and Care (NICE) in the United Kingdom is not applicable through a survey of multi-ethnic populations in the United Kingdom.
For everyone, a lower BMI level in the Chinese population will increase the incidence of type 2 diabetes.
The critical value of "type 2 diabetes risk" found in the study is much lower than the recommendations of WHO and NICE.
Based on these findings, the researchers recommend to revise the cut-off value of BMI for different populations to optimize the prevention, early diagnosis and early management of type 2 diabetes.
Screenshot source: The Lancet Diabetes & Endocrinology The study was led by scholars from Oxford University and included 1,472,819 former and current diabetic-free subjects, aged ≥18 years, and BMI ranging from 15.
0 kg/m² to 50.
0 kg/m².
By.
Among them, whites accounted for 90.
6%, South Asians accounted for 5.
2%, blacks accounted for 3.
4%, Chinese accounted for 0.
7%, and Arabs accounted for 0.
2%.After a median follow-up of 6.
5 years, 97823 cases (6.
6%) were diagnosed with type 2 diabetes.
After adjusting for age and gender, the lower BMI levels of all ethnic groups are as follows, and the risk of developing type 2 diabetes is equivalent to that of whites with a BMI of 30.
0 kg/m² (the cut-off value for obesity): The cut-off value of BMI for the South Asian population is 23.
9 kg/m² The threshold BMI of the black population is 28.
1 kg/m² The threshold BMI of the Chinese population is 26.
9 kg/m² The threshold BMI of the Arab population is 26.
6 kg/m² ▲After adjusting for age and gender, each ethnic population has a different BMI threshold.
The incidence of type 2 diabetes is equivalent when the population BMI is 30.
0 kg/m².
(Screenshot source: Reference [1]) After adjusting for age and gender, the risk of developing type 2 diabetes is equivalent to that of whites with a BMI of 25.
0 kg/m² (the critical value for overweight) when the ethnic groups are at the following BMI levels: South Asia The cut-off value of BMI for the population is 19.
2 kg/m² The cut-off value for the BMI of the black population is 23.
4 kg/m² The cut-off value for the BMI of the Chinese population is 22.
2 kg/m² The cut-off value of BMI for the Arab population is 22.
1 kg/m² ▲After adjusting for age and gender, the ethnic groups are in The different BMI cut-off values are comparable to the incidence of type 2 diabetes in the white population with a BMI of 25.
0 kg/m².
(Screenshot source: Reference [1]) After further adjustment of smoking status and socio-economic status, the threshold of BMI of each ethnic group has not been substantially changed.
Type 2 diabetes can be prevented or delayed by changing diet, increasing physical activity, or using metformin.
Early use of other hypoglycemic treatments can reduce the risk of long-term complications of type 2 diabetes by controlling blood sugar.
The researchers point out that these benefits cannot be fully realized if there is insufficient understanding of obesity and the risks of developing type 2 diabetes.
Compared with the WHO recommendations and the NICE guidelines, the study shows that when the BMI value of African-Caribbean, South Asian, Chinese and Arab people living in the UK is significantly lower than the current defined obesity BMI threshold, the risk of developing type 2 diabetes is comparable to that of the UK The whites are pretty.
The "Lancet-Diabetes and Endocrinology" concurrent review article pointed out that different ethnic groups have different thresholds for obesity-related diabetes risk, and it is not recommended to use a unified BMI threshold to screen and prevent type 2 diabetes.
The study also supports the view that a strict BMI cut-off value should not be used as an independent standard for defining indications for obesity therapy, especially not recommended as an independent standard for indications for weight loss and metabolic surgery.
"It is becoming increasingly clear that whether we regard obesity as a risk factor for future diseases or the disease itself, there are many serious shortcomings in BMI as an indicator of obesity.
If different ethnic groups have different BMI thresholds for the risk of diabetes
If obesity is regarded as a disease, the BMI cut-off value for determining the risk of other obesity-related diseases or death may also be different.
” The review article further proposes that if obesity is regarded as a disease, whether BMI has clinical significance and whether it can be used as a diagnosis basis for the disease.
It is worth thinking about whether or not obesity is defined entirely through BMI. Related reading "The Lancet" sub-issue cover report: Half of the Chinese are fat! With so many "fat" factors, how many have you gotten? Why is it easy to get diabetes when getting fat? "The Lancet" sub-journal research reveals that excess fat affects metabolic disorders.
AHA scientific statement: Obesity has multiple hazards to the cardiovascular system, and waist thickness should also be paid attention to! How to reduce the most useful? JAMA 32 years of big data: 10 years of early diabetes, double the risk of dementia! "Nature" review: More and more young people have type 2 diabetes.
How serious are the consequences? The disease progression and complications are terrible! Source of title map: 123RF References: [1] Caleyachetty, R.
, et al.
, (2021).
Ethnicity-specific BMI cutoffs for obesity based on type 2 diabetes risk in England: a population-based cohort study.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00088-7[2] Francesco Rubino,David E Cummings.
(2021).
Obesity: what's in a word?.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00122-4[3] Study of 1.
5 million British people shows BMI cut offs for obesity and diabetes risk do not work for non-white populations.
Retrieved 11-MAY-2021, from Note: This article aims to introduce the progress of medical and health research, not a treatment plan recommendation. If you need guidance on the treatment plan, please go to a regular hospital for treatment.
