Using the 2013/14 New York City (NYC) Health and Nutrition Examination Survey, we compared disease burden of Afro-Caribbeans and African Americans by a) estimating prevalence and odds of type 2 diabetes (T2DM), and b) examining ethnicity-specific risk profiles.
We analyzed data for Afro-Caribbean (n=81) and African American (n=118) participants. T2DM was defined as prior diagnosis; HbA1c≥6.5%; or fasting glucose ≥126mg/dL. Logistic regression estimated odds of type 2 diabetes by BMI category, waist circumference, and physical activity, adjusting for socioeconomic confounders. Among Afro-Caribbeans (Age (Mean±SE) 49±2years, BMI 29.2±0.7kg/m2) and African Americans (Age 46±2years, BMI 30.3±0.9kg/m2) T2DM prevalence was 31% and 21% respectively.
Compared to African Americans, Afro-Caribbeans with T2DM had lower mean BMI (29.9 ±0.8kg/m2 vs. 34.6 ±1.78kg/m2, P=0.01), lower waist circumference (102 ±2cm vs. 114 ±3cm, P=0.0015) and higher HDL levels (50.6±2.5 mg/dL vs. 42.5±3.2 mg/dL, P=0.0519). Afro-Caribbeans with T2DM were more likely to be overweight (57.2% vs. 13.5%) than obese (33.2% vs. 74.7%), yet less likely to meet HP2010 physical activity goals (23.6% vs 35.3%). In Afro-Caribbeans waist circumference increased T2DM odds by 18%. Low levels of physical activity was also associated with greater odds of diabetes [aOR=7.03 (95% CI 1.19-41.53), P=0.0314].
Compared to those without T2DM, T2DM cases had higher triglycerides. The difference in HDL levels between T2DM cases and those without T2DM was much greater in African Americans than in Afro-Caribbeans.
To enhance detection of diabetes among Afro-Caribbeans and African Americans in New York City, screening criteria should consider unique measures of risk in each population.