ESPEYB18 12. Obesity and Weight Regulation Type 2 Diabetes (7 abstracts)
12.6. Adolescent BMI and early-onset type 2 diabetes among Ethiopian immigrants and their descendants: a nationwide study
Simchoni M , Hamiel U , Pinhas-Hamiel O , Zucker I , Cukierman-Yaffe T , Lutski M , Derazne E , Beer Z , Behar D , Keinan-Boker L , Mosenzon O , Tzur D , Afek A , Tirosh A , Raz I & Twig G
Cardiovasc Diabetol. 2020 Oct 6;19(1):168. 10.1186/s12933-020-01143-z. PMID: 33023586.
In brief: The impact of immigration on the risk of early-onset T2DM (before age 40 years) was assessed in a nationwide cohort. Data on 93 806 native Israelis and 27 684 Israelis of Ethiopian origin, assessed at a mean age 17.5 years, were linked to the Israeli National Diabetes Registry. After adjustment for sociodemographic confounders, the hazard ratios for T2DM among Ethiopian men with normal and high BMI were 3.4 (2.3–5.1) and 15.8 (8.3–30.3), respectively, compared to third-generation Israelis with normal BMI. When the analysis was limited to Israeli-born Ethiopian men, the hazard ratios increased to 4.4 (1.7–11.4) and 29.1 (12.9–70.6), respectively.
Comment: The total number of international migrants at mid-year 2020 was 280.6 million, of whom 14.6% were aged <19 years. International migration has increased over time, both numerically and proportionally, at a slightly faster rate than previously anticipated. Migration has implications on public health, and addressing migration-associated health threats is crucial.
In the current population-based study, higher incidence of early-onset T2DM was observed in persons of Ethiopian origin than among native Israelis. T2DM was diagnosed at a mean age of 30 years. The crude incidence rate for early-onset T2DM at age 17 years was calculated according to BMI groups. T2DM incidence was higher in Ethiopian vs. native Israeli males in the underweight, normal weight and overweight/obese groups. This suggests increased risk for early-onset T2DM among adolescent males of Ethiopian origin, even those with BMI within the normal range. Those with overweight and obesity were found to be at considerably greater risk.
The incidence of diabetes increased with the time interval since immigration; the risk for early-onset T2DM was higher for those of Ethiopian origin born in Israel than for those born in Ethiopia. This suggests an important contribution of lifestyle changes among Ethiopian immigrants to Israel, who changed their diet to a more Western one, and became less physically active, and also indicate that exposure during postnatal and early childhood are important.
These findings emphasize the need for interventions aimed at obesity prevention, education about healthy lifestyles, and early medical intervention. The findings have implications to other high-income countries that are recipients of immigrants. Ensuring that health services are delivered to migrants in a culturally and linguistically appropriate way is of high priority. https://migrationdataportal.org/data?i=stock_abs_&t=2020
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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