Metabolic Syndrome and Related Disorders
Volume 12, Issue 6, 2014, Pages 347-353

Worse cardiometabolic health in African immigrant men than African American Men: Reconsideration of the healthy immigrant effect (Article)

O'connor M.Y. , Thoreson C.K. , Ricks M. , Courville A.B. , Thomas F. , Yao J. , Katzmarzyk P.T. , Sumner A.E.*
  • a Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
  • b Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
  • c Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States
  • d Nutrition Department of the Clinical Center, National Institutes of Health, Bethesda, MD, United States
  • e Radiology Department of the Clinical Center, National Institutes of Health, Bethesda, MD, United States
  • f Radiology Department of the Clinical Center, National Institutes of Health, Bethesda, MD, United States
  • g Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, United States
  • h Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States

Abstract

Background: The healthy immigrant effect is a phrase that has been used for decades to describe better cardiometabolic health in African immigrants than African Americans. The recent global increase in cardiometabolic diseases raises the possibility that immigrant health may be changing. Therefore, a new assessment of cardiometabolic health in African immigrants is warranted. Methods: Glucose tolerance status, blood pressure, and visceral adipose tissue (VAT) volume were compared in 214 self-identified healthy men comprised of 138 African immigrants, 76 African Americans, mean age 36±9 years [mean±standard deviation (SD); range 20-64 years]. Insulin resistance was defined by the lowest quartile of the insulin sensitivity index (S I≤2.28mU/L-1·min-1). The waist circumference (WC) which predicts insulin resistance was determined using receiver operating characteristic curves and the Youden index. Results: Body mass index (BMI) and WC were lower in African immigrants than African Americans (BMI, 27.4±3.8 vs. 29.3±5.5 kg/m2, P<0.01; WC, 91±11 vs. 97±16cm, P<0.01). However, blood pressure, fasting glucose, and 2-hr glucose were higher in the African immigrants (all P<0.01). In addition, African immigrants had a higher prevalence of previously undiagnosed diabetes (8% vs. 0%, P<0.01) and prediabetes (35% vs. 22%, P<0.01). After adjusting for WC, African immigrants had more visceral adipose tissue (VAT) than African Americans (P<0.01). Consequently, the WC that predicted insulin resistance was 92cm in African immigrants but 102cm in African Americans. Conclusion: African immigrants were less obese than African Americans but had worse cardiometabolic health, specifically higher glucose levels, more hypertension, and greater visceral adiposity. Overall, the healthy immigrant effect may no longer be valid. © Mary Ann Liebert, Inc. 2014.

Author Keywords

[No Keywords available]

Index Keywords

Blood Glucose immigrant insulin resistance receiver operating characteristic metabolism blood pressure Waist Circumference Cardiovascular Diseases correlation analysis intraabdominal fat human clinical assessment Youden index middle aged Cohort Studies statistics and numerical data diabetes mellitus metabolic disorder obesity priority journal health status hypertension insulin sensitivity ethnology African American cardiometabolic risk United States Young Adult Humans migrant cardiovascular disease male Emigrants and Immigrants female risk factor Abdominal Fat Africa prevalence Article glucose tolerance glucose blood level adult human experiment body weight age Age Factors cohort analysis normal human glucose body mass Metabolic Diseases African Americans pathophysiology impaired glucose tolerance
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84904812674&doi=10.1089%2fmet.2014.0026&partnerID=40&md5=65e042ab240753045933b6fc63ce86fc
DOI: 10.1089/met.2014.0026
ISSN: 15404196
Cited by: 24
Original Language: English