Diabetes mellitus and obesity among South Asians with ischemic stroke across three countries
Ken-Dror, Gie Ajami, Intisar Han, Thang S Aurelius, Taylor Maheshwari, Ankita Hail, Hassan Al Deleu, Dirk Sharma, Sapna D Amlani, Sageet Gunathilagan, Gunaratnam
Ken-Dror, Gie
Ajami, Intisar
Han, Thang S
Aurelius, Taylor
Maheshwari, Ankita
Hail, Hassan Al
Deleu, Dirk
Sharma, Sapna D
Amlani, Sageet
Gunathilagan, Gunaratnam
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Affiliation
University of London; Ashford and St Peter's Hospitals NHS Foundation Trust; New Delhi & Rajendra Institute of Medical Sciences; Hamad Medical Corporation; BARTS and the London NHS Trust; Queen Elizabeth the Queen Mother Hospital; Northwick Park Hospital; Brighton and Sussex University Hospitals NHS Trust; University of Sussex; Bradford Teaching Hospital; Birmingham City Hospital; William Harvey Hospital; Hillingdon Hospital; Luton and Dunstable Hospital; Newham University Hospital; Croydon University Hospital; West Middlesex University; Leeds General Infirmary; New Cross Hospital; Walsall Healthcare NHS Trust; Queen's Park Hospital Royal Blackburn; Birmingham Heartlands Hospital; Airedale General Hospital; North Eastern Indira Gandhi Regional Institute for Health and Medical Sciences; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Ashford and St Peter's NHS Foundation Trust; Imperial College Healthcare NHS Trust
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Publication date
2023-09-29
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Abstract
Background: Diabetes mellitus and central obesity are more common among South Asian populations than among White British people. This study explores the differences in diabetes and obesity in South Asians with stroke living in the United Kingdom, India, and Qatar compared with White British stroke patients.
Methods: The study included the UK, Indian, and Qatari arms of the ongoing large Bio-Repository of DNA in Stroke (BRAINS) international prospective hospital-based study for South Asian stroke. BRAINS includes 4580 South Asian and White British recruits from UK, Indian, and Qatar sites with first-ever ischemic stroke.
Results: The study population comprises 1751 White British (WB) UK residents, 1165 British South Asians (BSA), 1096 South Asians in India (ISA), and 568 South Asians in Qatar (QSA). ISA, BSA, and QSA South Asians suffered from higher prevalence of diabetes compared with WB by 14.5% (ISA: 95% confidence interval (CI) = 18.6-33.0, p < 0.001), 31.7% (BSA: 95% CI = 35.1-50.2, p < 0.001), and 32.7% (QSA: 95% CI = 28.1-37.3, p < 0.001), respectively. Although WB had the highest prevalence of body mass index (BMI) above 27 kg/m2 compared with South Asian patients (37% vs 21%, p < 0.001), South Asian patients had a higher waist circumference than WB (94.8 cm vs 90.8 cm, p < 0.001). Adjusting for traditional stroke risk factors, ISA, BSA, and QSA continued to display an increased risk of diabetes compared with WB by 3.28 (95% CI: 2.53-4.25, p < 0.001), 3.61 (95% CI: 2.90-4.51, p < 0.001), and 5.24 (95% CI: 3.93-7.00, p < 0.001), respectively.
Conclusion: South Asian ischemic stroke patients living in Britain and Qatar have a near 3.5-fold risk of diabetes compared with White British stroke patients. Their body composition may partly help explain that increased risk. These findings have important implications for public health policymakers in nations with large South Asian populations.
Citation
Ken-Dror G, Ajami I, Han TS, Aurelius T, Maheshwari A, Hail HA, Deleu D, Sharma SD, Amlani S, Gunathilagan G, Cohen DL, Rajkumar C, Maguire S, Ispoglou S, Balogun I, Parry A, Sekaran L, Syed H, Lawrence E, Singh R, Hassan A, Wharton C, Javaid K, Goorah N, Carr P, Abdus Sami E, Ali M, Hussein HA, Osman Abuzaid H, Sharif K, Ram Sharma S, Sylaja PN, Yousef Khan F, Prasad K, Sharma P. Diabetes mellitus and obesity among South Asians with ischemic stroke across three countries. Int J Stroke. 2024 Feb;19(2):235-243. doi: 10.1177/17474930231203149. Epub 2023 Sep 29.
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Article