Skinfold thickness and the incidence of type 2 diabetes mellitus and hypertension: An analysis of the Peru MIGRANT study

Andrea Ruiz-Alejos
,
Rodrigo M. Carrillo-Larco
,
J. Jaime Miranda
,
Robert H. Gilman
,
Liam Smeeth
,
Antonio Bernabé-Ortiz(corresponding author)

*Corresponding author for this work

Universidad Peruana Cayetano Heredia
,
Universidad Peruana Cayetano Heredia
,
Johns Hopkins University
,
London School of Hygiene and Tropical Medicine

Research Output:

Contribution to journal

Article

Peer-review

Open access

Publication Information

Output type

Research Output:

Contribution to journal

Article

Peer-review

Original language

English

Pages from-to (Number of pages)

Pages 63-71 (9 pages)

Journal (Volume, Issue Number)

Public Health Nutrition (Volume 23, Issue 1)

Publication milestones

Published - 01/01/2020

Publication status

Published - 01/01/2020

ISSN

1368-9800

Publication IDs

Scopus: 85066852426
PubMed: 31159908

Abstract

Objective: To determine the association between excess body fat, assessed by skinfold thickness, and the incidence of type 2 diabetes mellitus (T2DM) and hypertension (HT).Design: Data from the ongoing PERU MIGRANT Study were analysed. The outcomes were T2DM and HT, and the exposure was skinfold thickness measured in bicipital, tricipital, subscapular and suprailiac areas. The Durnin-Womersley formula and SIRI equation were used for body fat percentage estimation. Risk ratios and population attributable fractions (PAF) were calculated using Poisson regression.Setting: Rural (Ayacucho) and urban shantytown district (San Juan de Miraflores, Lima) in Peru.Participants: Adults (n 988) aged ≥30 years (rural, rural-to-urban migrants, urban) completed the baseline study. A total of 785 and 690 were included in T2DM and HT incidence analysis, respectively.Results: At baseline, age mean was 48·0 (sd 12·0) years and 47 % were males. For T2DM, in 7·6 (sd 1·3) years, sixty-one new cases were identified, overall incidence of 1·0 (95 % CI 0·8, 1·3) per 100 person-years. Bicipital and subscapular skinfolds were associated with 2·8-fold and 6·4-fold risk of developing T2DM. On the other hand, in 6·5 (sd 2·5) years, overall incidence of HT was 2·6 (95 % CI 2·2, 3·1) per 100 person-years. Subscapular and overall fat obesity were associated with 2·4- and 2·9-fold risk for developing HT. The PAF for subscapular skinfold was 73·6 and 39·2 % for T2DM and HT, respectively.Conclusions: We found a strong association between subscapular skinfold thickness and developing T2DM and HT. Skinfold assessment can be a laboratory-free strategy to identify high-risk HT and T2DM cases.

Funding Details

Acknowledgements: The authors are in high debt to the participants from Ayacucho and Lima, who kindly agreed and completed their participation in the study. In addition, they want to recognize and thank the commitment and hard work of all the fieldworkers, especially Lilia Cabrera, Rosa Salirrosas and Marco Varela. Financial support: This study was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, through the GloCal Health Fellowship Program from the University of California Global Health Institute and partly under the contract number HHSN268200900033 C. A.R.-A. is supported by the GloCal Health Fellowship Program. A.B.-O. (103994/Z/14/Z), J.J.M. (205177/Z/16/Z) and L.S. (098504/Z/12/Z) are supported by the Wellcome Trust. R.M.C.-L. has received support by the Inter-American Institute for Global Change Research (IAI CRN3036). The funders had no role in the design, analysis or writing of this article. Conflict of interest: The authors declare neither competing nor conflicts of interests. Authorship: J.J.M., A.B.-O., L.S. and R.H.G. conceived the original idea of the PERU MIGRANT Cohort Study including the further studies obtained with the follow-ups. The authors were part of the design and supervision. A.R.-A. coordinated and supervised fieldwork activities during the second follow-up conducted between 2015 and 2016. A.B.-O., A.R.-A. and J.J.M. developed the idea of this manuscript. A.B.-O. led the statistical analysis supported by R.M.C.-L. and A.R.-A. A.R.-A. drafted the first version of the article with great input of A.B.-O., R.M.C.-L. and J.J.M. All authors participated in writing the manuscript, provided key intellectual content and gave their final approval of the version submitted for publication. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Ethics Committees of Universidad Peruana Cayetano Heredia (UPCH) in Peru and the London School of Hygiene and Tropical Medicine in the UK at baseline. Further follow-up assessments were approved by the Ethics Committee at UPCH. Written or verbal informed consent were obtained from all subjects. When verbal consent was obtained it was witnessed and formally recorded.

FundersFunding numbers

University of California Global Health Institute

HHSN268200900033, 205177/Z/16/Z, 098504/Z/12/Z, 103994/Z/14/Z

NIH

NHLBI