BMI and Diabetes Risk in Singaporean Chinese

OBJECTIVE Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce. RESEARCH DESIGN AND METHODS This study was a prospective analysis of 37,091 men and women aged 45–74 years in the Singapore Chinese Health Study, using Cox regression analysis. RESULTS Risk of incident type 2 diabetes significantly increased beginning with BMIs 18.5–23.0 kg/m 2 (relative risk 2.47 [95% CI 1.75–3.48]) and continued in a monotonic fashion across the spectrum of BMI. Results were stronger for younger than for older adults. CONCLUSIONS BMIs considered lean and normal in Singaporean Chinese are strongly associated with increased risk of incident type 2 diabetes. This association weakened with advanced age but remained significant.