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Article

Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations

1
School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle 2308, New South Wales, Australia
2
UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
3
Clinical Research Design, IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, Newcastle 2305, New South Wales, Australia
4
Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle 2308, New South Wales, Australia
5
Hunter Area Pathology Service, John Hunter Hospital, Newcastle 2305, New South Wales, Australia
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(12), 2813; https://doi.org/10.3390/ijerph15122813
Received: 29 October 2018 / Revised: 3 December 2018 / Accepted: 4 December 2018 / Published: 10 December 2018
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
The prevalence of type 2 diabetes is escalating rapidly in Asian countries, with the rapid increase likely attributable to a combination of genetic and lifestyle factors. Recent research suggests that common genetic risk variants contribute minimally to the rapidly rising prevalence. Rather, recent changes in dietary patterns and physical activity may be more important. This nested case-control study assessed the association and predictive utility of type 2 diabetes lifestyle risk factors in participants from Malaysia, an understudied Asian population with comparatively high disease prevalence. The study sample comprised 4077 participants from The Malaysian Cohort project and included sub-samples from the three major ancestral groups: Malay (n = 1323), Chinese (n = 1344) and Indian (n = 1410). Association of lifestyle factors with type 2 diabetes was assessed within and across ancestral groups using logistic regression. Predictive utility was quantified and compared between groups using the Area Under the Receiver-Operating Characteristic Curve (AUC). In predictive models including age, gender, waist-to-hip ratio, physical activity, location, family history of diabetes and average sleep duration, the AUC ranged from 0.76 to 0.85 across groups and was significantly higher in Chinese than Malays or Indians, likely reflecting anthropometric differences. This study suggests that obesity, advancing age, a family history of diabetes and living in a rural area are important drivers of the escalating prevalence of type 2 diabetes in Malaysia. View Full-Text
Keywords: type 2 diabetes; Asian populations; risk factor; genetic; rural; Malaysia type 2 diabetes; Asian populations; risk factor; genetic; rural; Malaysia
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MDPI and ACS Style

Abdullah, N.; Abdul Murad, N.A.; Attia, J.; Oldmeadow, C.; Kamaruddin, M.A.; Abd Jalal, N.; Ismail, N.; Jamal, R.; Scott, R.J.; Holliday, E.G. Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations. Int. J. Environ. Res. Public Health 2018, 15, 2813. https://doi.org/10.3390/ijerph15122813

AMA Style

Abdullah N, Abdul Murad NA, Attia J, Oldmeadow C, Kamaruddin MA, Abd Jalal N, Ismail N, Jamal R, Scott RJ, Holliday EG. Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations. International Journal of Environmental Research and Public Health. 2018; 15(12):2813. https://doi.org/10.3390/ijerph15122813

Chicago/Turabian Style

Abdullah, Noraidatulakma; Abdul Murad, Nor A.; Attia, John; Oldmeadow, Christopher; Kamaruddin, Mohd A.; Abd Jalal, Nazihah; Ismail, Norliza; Jamal, Rahman; Scott, Rodney J.; Holliday, Elizabeth G. 2018. "Differing Contributions of Classical Risk Factors to Type 2 Diabetes in Multi-Ethnic Malaysian Populations" Int. J. Environ. Res. Public Health 15, no. 12: 2813. https://doi.org/10.3390/ijerph15122813

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