Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.360597
Title: Obesity, body fat distribution and other risk factors of non-insulin-dependent diabetes mellitus in different ethnic groups living in East Anglia
Author: Bose, Kaushik Sankar
ISNI:       0000 0001 3471 2418
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 1995
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Abstract:
This thesis reports on the prevalences of non-insulin-dependent diabetes mellitus, obesity, hypertension, hypercholesterolaemia and various indicators of lifestyle patterns in 262 adult White and 139 Asian (persons originating from the Indian subcontinent) males living in East Anglia. The Asians were subdivided into two groups, Indians and Pakistanis. The thesis elucidates the similarities, differences and interrelationships of various anthropometric, metabolic and blood pressure variables and indices in the different ethnic groups. It also investigates the role of generalised adiposity as well as body fat distribution as a risk factor of diabetes, hypertension and hypercholesterolaemia in the ethnic groups. Asians (Indians and Pakistanis combined) had significantly higher prevalence of NIDDM but significantly lower prevalence of hypercholesterolaemia compared to Whites. There were significant differences in a variety of reported indicators of lifestyle patterns between Indians/ Pakistanis and Whites. Significant heterogeneity in body fat patterning and metabolic variables was observed between Indians/Pakistanis and Whites. Indians and Pakistanis had significantly more truncal, upper and central body subcutaneous adiposity but significantly less forearm subcutaneous adiposity than Whites; they also had significantly more total subcutaneous fat but significantly less visceral truncal fat. All three ethnic groups had similar levels of generalised adiposity. Overall, 77.0% and 93.5% of Indians/Pakistanis and Whites respectively could be correctly classified by using variqus anthropometric and metabolic variables and indices. Indians and Pakistanis had significantly lower mean total cholesterol (age corrected) but significantly higher mean diastolic blood pressure compared with Whites. Results of correlation studies revealed that age had a similar association with all the metabolic and blood pressure variables in the ethnic groups. The distributions (age controlled) of total cholesterol, systolic and diastolic blood pressure were significantly different between Indians/Pakistanis and Whites. The results also provided evidence of significant association between some anthropometric variables and indices with fasting blood glucose, total cholesterol, systolic and diastolic blood pressure in all three ethnic groups. In some instances significant heterogeneity was observed in the correlations of anthropometric variables and indices with the metabolic and blood pressure variables between the ethnic groups. Body mass index (BMI) showed significant positive association with systolic blood pressure (after controlling for age and age 2) in all the ethnic groups. The distributions (age and BMI controlled) of total cholesterol and systolic blood pressure were significantly different between Indians/Pakistanis and Whites. Overall, Indians and Pakistanis had significantly lower mean BMI after removing the effects of age, age 2 and upper body subcutaneous adiposity; central body subcutaneous adiposity; and fasting blood glucose, cholesterol and systolic blood pressure. All the measures of central subcutaneous adiposity (abdomen skinfold, suprailiac skinfold and the sum of abdomen and suprailiac skinfolds) had significant positive associations (after controlling for age, age 2 and BMI) with fasting blood glucose in Whites but not in Indians and Pakistanis. Significant heterogeneity was observed in the partial correlation coefficients (age effect removed) of these measures with fasting blood glucose between Whites and Indians/Pakistanis. Central subcutaneous adiposity was thus found to be a potential ethnic-specific risk factor (independent of age and generalised obesity) of NIDDM in Whites but not in Indians and Pakistanis. Asians had significantly lower mean cholesterol (age corrected) than Whites after controlling for the effects of circumferences; upper body skinfolds; central body skinfolds; extremity skinfolds; and BMI, fasting blood glucose and systolic blood pressure. Indians and Pakistanis had significantly higher and lower mean systolic blood pressure (age corrected) than Whites respectively, after removing the effects of circumferences; upper body skinfolds; central body skinfolds; extremity skinfolds; and fasting blood glucose, cholesterol and body mass index. Although there was some overlap in which variables best predicting fasting blood glucose, total cholesterol and systolic blood pressure in the three ethnic groups, the most important predictive variables differed in the three groups. The anthropometric variables and indices used in predicting fasting blood glucose, total cholesterol and systolic blood pressure in White only group provided poor prediction of the means of these three variables in Indians and Pakistanis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.360597  DOI:
Keywords: Medicine
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