T.H.MINA1, N.A. ABDUL-AZIZ1, T.Y.Y. TONG1, G.K. WANSAICHEONG2, R. DALAN2, E.S. LEE3, J. LEE4, P. ELLIOTT5, E. RIBOLI5, J. NGEOW6, M. LOH1, J.C. CHAMBERS1
Nanyang Technological University1, Tan Tock Seng Hospital2, NHG Polyclinics3, Institute of Mental Health4, Imperial College London5, National Cancer Centre Singapore6
Excess adiposity is a risk factor for various metabolic symptoms. Both adiposity and metabolic phenotypes significantly differ across ethnicity, including in South-East Asian (SEA) population. We hypothesized that adiposity and lean mass could explain ethnic differences in metabolic phenotypes in the multi-ethnic SEA population using HELIOS, a prospective multi-ethnic cohort study in Singapore.
We measured the associations of ethnicity and baseline metabolic phenotypes (blood pressure, fasting high-density lipoprotein (HDL), triglyceride, glucose and glycated hemoglobin (HbA1c)), adjusting for anthropometric and Dual-Energy X-ray absorptiometry-based adiposity and lean mass indices (seven Fat Mass Indices (FMI), three Lean Mass Indices (LMI), five fat distribution ratios) amongst 5332 participants.
Compared to Chinese, Malay and South Asian participants had elevated FMIs across fat depots, lower LMI/FMI (lean-to-fat) ratio, and poorer metabolic profile, independent of age and gender (p<0.001). Adjusting for visceral adiposity and LMI/FMI ratio abolished the ethnic difference in blood pressure (Mean difference ?x? [SE] SBP Malay-Chinese= 2.96[0.92] mmHg; ?x? SBP South Asian-Chinese= 3.48[0.69] mmHg) and triglycerides (?x?Malay-Chinese= 0.26[0.03] mmol/L; ?x?South Asian-Chinese= 0.18 [0.02] mmol/L). The ethnic difference in HDL (?x?Malay-Chinese= -0.19 [0.02] mmol/L; ?x?South Asian-Chinese= -0.30 [0.02] mmol/L), glucose (?x?Malay-Chinese= 0.51[0.06] mmol/L; ?x?South Asian-Chinese= 0.64 [0.05] mmol/L) and HbA1c (?x?Malay-Chinese= 0.39[0.04] %; ?x?South Asian-Chinese= 0.52 [0.03] %) remained present after adjusting for adiposity or lean mass (p<0.001).
Adiposity and lean mass composition and distribution could explain ethnic difference in metabolic phenotypes in SEA population. Preventative and management strategies to reduce excess adiposity and improve lean mass should consider ethnic difference in this population.